Provider Demographics
NPI:1376158998
Name:DEAN TURNER, MARY L (PHMNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:DEAN TURNER
Suffix:
Gender:F
Credentials:PHMNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 STONETRACE DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-3054
Mailing Address - Country:US
Mailing Address - Phone:901-488-4839
Mailing Address - Fax:
Practice Address - Street 1:6727 STONETRACE DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-3054
Practice Address - Country:US
Practice Address - Phone:901-488-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2020006750363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health