Healthcare Provider Details

I. General information

NPI: 1598787350
Provider Name (Legal Business Name): MARY ANN BOND APRN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ANN NEW MSN

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOPKINS AVE.
BELLS TN
38006-4500
US

IV. Provider business mailing address

PO BOX 1058
BELLS TN
38006-1058
US

V. Phone/Fax

Practice location:
  • Phone: 731-663-0951
  • Fax: 731-663-0941
Mailing address:
  • Phone: 731-663-0951
  • Fax: 731-663-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP0005413
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0044671
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: