Provider Demographics
NPI:1598787350
Name:BOND, MARY ANN (APRN MSN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:BOND
Suffix:
Gender:F
Credentials:APRN MSN
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:NEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:PO BOX 1058
Mailing Address - Street 2:
Mailing Address - City:BELLS
Mailing Address - State:TN
Mailing Address - Zip Code:38006-1058
Mailing Address - Country:US
Mailing Address - Phone:731-663-0951
Mailing Address - Fax:731-663-0941
Practice Address - Street 1:113 HOPKINS AVE.
Practice Address - Street 2:
Practice Address - City:BELLS
Practice Address - State:TN
Practice Address - Zip Code:38006-4500
Practice Address - Country:US
Practice Address - Phone:731-663-0951
Practice Address - Fax:731-663-0941
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAP0005413363L00000X
TNRN0044671163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN112837OtherUNISON HEALTH CARE
462314115OtherCOMMERICAL PLANS
TN20211OtherTLC
TN621856393OtherUAHC
TN1598787350OtherGROUP NPI # 1280556733
TN3347868Medicaid
TN4020412OtherBCBS TN CARE SELECT
TN621856393OtherALL OTHER COMMERCIAL PLAN
S76345Medicare UPIN
TN621856393OtherUAHC