Provider Demographics
NPI:1558584409
Name:BARNES, MARY G (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:G
Last Name:BARNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COUNTY SERVICES RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1748
Mailing Address - Country:US
Mailing Address - Phone:615-792-4318
Mailing Address - Fax:615-792-6794
Practice Address - Street 1:162 COUNTY SERVICES RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1748
Practice Address - Country:US
Practice Address - Phone:615-792-4318
Practice Address - Fax:615-792-6794
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN148801163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN148801OtherRN