| Doctor Name: | MARY ANN LIGHT |
| NPI Number: | 1720095086 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 12784 |
| Business Practice Address: | 796 Ridgeway Ave Signal Mountain, TN - 373773067 |
| Business Phone Number: | 4238863269 |
| Business Fax Number: | |
| Mailing Address: | Po Box 772, WOONSOCKET |
| State: | RI |
| Postal Code: | 028950784 |
| Phone Number: | 4017705779 |
| Fax Number: | 4016529787 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 06/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 12784 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |