Healthcare Provider Details

I. General information

NPI: 1407774052
Provider Name (Legal Business Name): DESTINY MARIA MAY MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HIGHWAY 70 E
DICKSON TN
37055-2080
US

IV. Provider business mailing address

111 HIGHWAY 70 E
DICKSON TN
37055-2080
US

V. Phone/Fax

Practice location:
  • Phone: 615-446-0446
  • Fax:
Mailing address:
  • Phone: 615-446-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number42489
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: