MARY ROSS NPI 1124402698

NPI Information

  • NPI: 1124402698
  • Provider Name: MARY ROSS
  • Classification: Registered Nurse - 163WC1500X
  • Specialization: Community Health
  • Entity Type: Individual
  • Address: 10825 OLD HIGHWAY 64
    BOLIVAR, TN
    ZIP 38008
  • Phone: (731) 658-5291

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NPI Details

Mary Ross is a community health registered nurse in Bolivar, TN. Mary Ross NPI is 1124402698. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10825 OLD HIGHWAY 64
BOLIVAR, TN
ZIP 38008-599
Phone: (731) 658-5291
Fax: (731) 658-6536

The enumeration date for this NPI number is 7/15/2015 and was last updated on 7/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WC1500XRegistered NurseCommunity Health0000095307TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1626001445OTHERTENNESSEESTATE OF TN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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