Provider Demographics
NPI:1659601094
Name:FEREBEE, MARY E V (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E V
Last Name:FEREBEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HIGHWAY 70 E STE D
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2075
Mailing Address - Country:US
Mailing Address - Phone:615-441-4503
Mailing Address - Fax:615-441-4575
Practice Address - Street 1:113 HIGHWAY 70 E STE D
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2075
Practice Address - Country:US
Practice Address - Phone:615-441-4503
Practice Address - Fax:615-441-4575
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14599363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMF2103769OtherDEA