Provider Demographics
NPI:1639298904
Name:SILCOX, MARY R (RNC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:R
Last Name:SILCOX
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W TYRONE RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6517
Mailing Address - Country:US
Mailing Address - Phone:865-482-1076
Mailing Address - Fax:865-481-6179
Practice Address - Street 1:110 N TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-2425
Practice Address - Country:US
Practice Address - Phone:423-562-7426
Practice Address - Fax:423-562-4403
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38507163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health