Provider Demographics
NPI:1487157095
Name:SALERNO, MARY (APRN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SALERNO
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:SALERNO
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:413 GLENNS LEA
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-5212
Mailing Address - Country:US
Mailing Address - Phone:865-705-6279
Mailing Address - Fax:
Practice Address - Street 1:713 WINFIELD DNN PARKWAY
Practice Address - Street 2:STE 2 - 1027
Practice Address - City:SIVERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37876
Practice Address - Country:US
Practice Address - Phone:865-630-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-10
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23995363LP0808X
WA61093429363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health