MARY BLONDELL DEAL APN NPI 1841392974

NPI Information

NPI: 1841392974
Provider Name: MARY BLONDELL DEAL, APN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: FAST PACE MEDICAL CLINIC PLLC

PECOS Registration: Yes

Address:
31 PHYSICIANS DR
JACKSON, TN
ZIP 38305
Phone: (731) 664-0103
Get Directions

Mary Blondell Deal, APN is a family nurse practitioner in Jackson, TN with 28 years of experience. Mary Blondell Deal, APN NPI is 1841392974. 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:

31 PHYSICIANS DR
JACKSON, TN
ZIP 38305-071
Phone: (731) 664-0103
Fax: (731) 984-7272

The NPI 1841392974 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/1/2006 and was last updated on 4/21/2011.

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
1	363LF0000X	Nurse Practitioner	Family	APN5466	TENNESSEE	Yes

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
1	39006731	MEDICARE PIN	TENNESSEE
2	4162728	OTHER	TENNESSEE	BCBS
3	41975	OTHER	TENNESSEE	TLC
4	3900675	MEDICAID	TENNESSEE
5	S68391	MEDICARE UPIN	TENNESSEE
6	39006731	MEDICAID	TENNESSEE
7	3900675	MEDICARE PIN	TENNESSEE

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: 11/14/2023

NPI Synchronization or Removal

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