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General NPI Number Information
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NPI Number | 1699928093
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Entity Type | Organization
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Legal Business Name | MENTAL WELLNESS
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 1125 POPLAR VIEW LN S SUITE 1
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3168
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Country | US
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Telephone | 901-457-7871
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Fax | 901-457-7872
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Provider Business Mailing Address
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Address Line | 1125 POPLAR VIEW LN S SUITE 1
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3168
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Country | US
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Telephone | 901-457-7871
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Fax | 901-451-7872
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MS. SUSAN K SCHNUERER
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Credential | MSN, APRN, BC
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Telephone | 901-457-7871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN 7280
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License Number State | TN
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