Provider Demographics
NPI:1336472067
Name:RICHIE, MARY FERN (DSN, APRN-BC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FERN
Last Name:RICHIE
Suffix:
Gender:F
Credentials:DSN, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 FOXHALL CLOSE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1863
Mailing Address - Country:US
Mailing Address - Phone:615-351-1665
Mailing Address - Fax:615-460-4685
Practice Address - Street 1:900 GLENDALE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4230
Practice Address - Country:US
Practice Address - Phone:615-351-1665
Practice Address - Fax:615-460-4685
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health