1598787350 NPI number — MS. MARY ANN BOND APRN MSN

Table of content: MS. MARY ANN BOND APRN MSN (NPI 1598787350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598787350 NPI number — MS. MARY ANN BOND APRN MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOND
Provider First Name:
MARY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NEW
Provider Other First Name:
MARY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598787350
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1058
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38006-1058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-663-0951
Provider Business Mailing Address Fax Number:
731-663-0941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 HOPKINS AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38006-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-663-0951
Provider Business Practice Location Address Fax Number:
731-663-0941
Provider Enumeration Date:
07/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP0005413 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WC1500X , with the licence number: RN0044671 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112837 . This is a "UNISON HEALTH CARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 462314115 . This is a "COMMERICAL PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20211 . This is a "TLC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 621856393 . This is a "UAHC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1598787350 . This is a "GROUP NPI # 1280556733" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3347868 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4020412 . This is a "BCBS TN CARE SELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 621856393 . This is a "ALL OTHER COMMERCIAL PLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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