DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MARY REBECCA WALL FNP-C

MEDICARE: MARY REBECCA WALL FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPN0000025488TN
2363LF0000XFamily Nurse PractitionerAPN0000025488TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134689920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY REBECCA WALL FNP-C
Provider Business Mailing Address
First Line : 205 HOSPITAL DR STE A
Second Line :
City : MC KENZIE
State : TN
Zip : 38201-1649
Country : US
Telephone Number : 731-352-7907
Fax Number : 731-352-4459
Provider Business Practice Location Address
First Line : 136 S WILSON ST
Second Line :
City : DRESDEN
State : TN
Zip : 38225-1133
Country : US
Telephone Number : 731-364-4900
Fax Number : 731-352-4459
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 10/10/2025

Similar Medicare Providers

1720075633 — ELIZABETH A RIDDLE CFNP
Practice Location Address:
136 S WILSON ST
DRESDEN, TN
38225-1133
Practice Phone: 731-352-7907
Practice Fax: 731-364-4900
1881681666 — MARK A COOPER M.D.
Practice Location Address:
136 S WILSON ST
DRESDEN, TN
38225-1133
Practice Phone: 731-364-4900
Practice Fax: 731-352-4459
1497069603 — DR. FARRAH RAE VERNON D.O.
Practice Location Address:
136 S WILSON ST
DRESDEN, TN
38225-1133
Practice Phone: 731-364-4900
Practice Fax: 731-352-4459
1790075281 — MCKENZIE MEDICAL CENTER
Practice Location Address:
136 S WILSON ST # B
DRESDEN, TN
38225-1133
Practice Phone: 731-364-4923
Practice Fax: 731-364-4925
1497178693 — CCC MEDICAL EQUIPMENT, INC.
Practice Location Address:
136 S WILSON ST
DRESDEN, TN
38225-1133
Practice Phone: 731-584-7919
Practice Fax: 731-584-7920
1326430620 — ERIN NICOLE LEGENS
Practice Location Address:
136 S WILSON ST
DRESDEN, TN
38225-1133
Practice Phone: 731-364-4900
Practice Fax: 731-352-4459

Directions to “ MARY REBECCA WALL FNP-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.