Provider Demographics
NPI:1972928729
Name:HARLOW, MARY CLAIRE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CLAIRE
Last Name:HARLOW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:CLAIRE
Other - Last Name:HARLOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:6289 COMMON OAKS CT APT 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2685
Mailing Address - Country:US
Mailing Address - Phone:662-902-6984
Mailing Address - Fax:
Practice Address - Street 1:6289 COMMON OAKS CT APT 103
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2685
Practice Address - Country:US
Practice Address - Phone:662-902-6984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18389363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics