MARY REBECCA WALL (NPI# 1134689920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134689920 |
| Entity Type | Individual |
| Full Name | MARY REBECCA WALL |
| Credential | FNP-C |
| Practice Address |
136 S Wilson St Dresden TN 38225-1133 |
| Mailing Address |
205 Hospital Dr Ste A Mc Kenzie TN 38201-1649 |
| Practice Telephone | 7313644900 |
| Practice Fax Number | 7313524459 |
| Mailing Telephone | 7313527907 |
| Mailing Fax Number | 7313524459 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000025488 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3380640 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 205 Hospital Dr Ste A, Mc Kenzie, TN 382011649 | 7313527907 | 7313524459 |
| 301 Tyson Ave, Paris, TN 382424544 | 7316448445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467764522 | Mary Alice Wall | Counselor | 201 Lila Lane, Compass Health Skagit County Crisis Center, Burlington, WA 98223 | 2010-07-06 |
| 1780826636 | Mary Elizabeth Wall | Speech-Language Pathologist | 7 Coyote Court, Box 2290 Rdt, Nm 87557, Taos, NM 87571 | 2009-03-24 |
| 1417135559 | Mary Wall | Physical Therapist | 1446 Lawrence St, Eugene, OR 97401-4592 | 2008-01-31 |
| 1194900159 | Mary Louise Wall | Registered Nurse | W168n10737 Juniper Dr, Germantown, WI 53022-3964 | 2008-01-08 |
| 1265405237 | Mary Jean Wall | Radiology | 1001 Lakeside Ave E Ste 1200, Cleveland, OH 44114-1172 | 2006-02-09 |
| 1194161786 | Mary Bernadette Wall | Registered Nurse | 27175 Haggerty Rd, Novi, MI 48377-3626 | 2013-05-22 |
| 1265722300 | Mary Wall | Counselor | 230 Venture Cir, Nashville, TN 37228-1604 | 2011-04-11 |
| 1750593471 | Mary Claudia Wall | Social Worker | 123 W 79th St, Suite 208, New York, NY 10024-6480 | 2007-05-04 |
| Street Address |
136 S WILSON ST |
| City | DRESDEN |
| State | TN |
| Zip Code | 38225-1133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720075633 | Elizabeth A Riddle | Nurse Practitioner | 136 S Wilson St, Dresden, TN 38225-1133 | 2005-10-05 |
| 1326430620 | Erin Nicole Legens | Nurse Practitioner | 136 S Wilson St, Dresden, TN 38225-1133 | 2015-02-23 |
| 1497178693 | Ccc Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 136 S Wilson St, Dresden, TN 38225-1133 | 2014-01-24 |
| 1497069603 | Farrah Rae Vernon | Family Medicine | 136 S Wilson St, Dresden, TN 38225-1133 | 2010-07-29 |
| 1881681666 | Mark A Cooper | Internal Medicine | 136 S Wilson St, Dresden, TN 38225-1133 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164572327 | State of Tennessee | Public Health or Welfare | 9852 Hwy 22, Dresden, TN 38225 | 2007-01-11 |
| 1174626899 | Tennessee Cvs Pharmacy LLC | Pharmacy | 6616 Greenfield Hwy 54, Dresden, TN 38225 | 2006-09-07 |
| 1629284294 | Freds Stores of Tennessee Inc | Pharmacy | 8487 Highway 22, Dresden, TN 38225 | 2007-05-14 |
| 1790075281 | Mckenzie Medical Center | Pharmacy | 136 S Wilson St # B, Dresden, TN 38225-1133 | 2011-04-18 |
| 1225237928 | Richard Dale Hutcherson | Dentist | 106 W Maple St, Dresden, TN 38225-1141 | 2007-07-12 |
| 1922648237 | Clint Devan Raymer | Student in an Organized Health Care Education/Training Program | 344 Morrow St, Dresden, TN 38225-1324 | 2020-01-14 |
| 1770968034 | Kimberly Mcentire Hammonds | Counselor | 315 Hillcrest St, Dresden, TN 38225-1356 | 2015-07-28 |
| 1609833227 | Edwin Gwin Anderson | Optometrist | 113 E Locust St, Dresden, TN 38225-1440 | 2006-04-27 |
| 1316012099 | Optometric Center Professional Corporation | Optometrist | 113 E Locust St, Dresden, TN 38225-1440 | 2006-11-21 |
| 1033294467 | James Taylor Moss Jr. | Dentist | 107 E Locust St, Dresden, TN 38225-1440 | 2006-10-26 |
| Find all providers in zip 38225 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161766 | Rebecca Schaben | Nurse Practitioner | 8800 Frazeysburg Rd, Dresden, OH 43821-9473 | 2020-10-12 |
| 1295294833 | Devan Louise Sceurman | Nurse Practitioner | 4080 Red Bud Rd, Dresden, OH 43821-7527 | 2019-03-13 |
| 1902310618 | Shawdare Miriam Kelly | Nurse Practitioner | 914 High St, Dresden, OH 43821-9782 | 2017-11-17 |
| 1720075633 | Elizabeth A Riddle | Nurse Practitioner | 136 S Wilson St, Dresden, TN 38225-1133 | 2005-10-05 |
| 1588186688 | Lindsay Jessup | Nurse Practitioner | 1211 Chestnut St, Dresden, OH 43821-9738 | 2017-07-10 |
| 1326430620 | Erin Nicole Legens | Nurse Practitioner | 136 S Wilson St, Dresden, TN 38225-1133 | 2015-02-23 |
| 1407247935 | Allergy Treatment and Diagnostic Center, LLC | Nurse Practitioner | 130 E Locust St, Dresden, TN 38225-1467 | 2015-02-05 |
| 1346658663 | Barbara Montgomery | Nurse Practitioner | 8598 Highway 22, Dresden, TN 38225-2308 | 2014-07-30 |
| 1194098145 | Kelly Smith Barnes | Nurse Practitioner | 130 E Locust St, Dresden, TN 38225-1467 | 2012-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003731 | Erika Erickson | Nurse Practitioner | 2205 Steel Ct, Nolensville, TN 37135-9562 | 2020-11-06 |
| 1275134025 | Dara Downs | Nurse Practitioner | 1120 Glenview Dr, Nashville, TN 37206-3832 | 2020-11-06 |
| 1477154367 | Katrina Miller | Nurse Practitioner | 515 Lillard Rd, Murfreesboro, TN 37130-3131 | 2020-11-05 |
| 1780285932 | Caitlyn Lawson | Nurse Practitioner | 7637 Saddlebrooke Dr, Knoxville, TN 37938-4044 | 2020-11-04 |
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1154921120 | Melissa Ann Mcnutt | Nurse Practitioner | 941 Windsor Ave, Bristol, TN 37620-2155 | 2020-10-29 |
| 1033718960 | Kasi Wells | Nurse Practitioner | 1421 Porter Rd Ste 4, Nashville, TN 37206-1669 | 2020-10-21 |
| 1730787193 | Nancy Katherine Ray | Nurse Practitioner | 4576 Poplar Ave, Memphis, TN 38117-7502 | 2020-10-16 |
| 1407454101 | Jason D Jones | Nurse Practitioner | 213 Austell Dr, Columbia, TN 38401-5531 | 2020-10-14 |
| 1295333045 | Alma Sue Moore | Nurse Practitioner | 14 Shady Lane Est, Humboldt, TN 38343-6650 | 2020-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.