Healthcare Provider Details

I. General information

NPI: 1326186453
Provider Name (Legal Business Name): JOAN ELIZABETH POPKIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 05/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5364 VILLAGE WAY
NASHVILLE TN
37211-6234
US

IV. Provider business mailing address

230 CARDEN AVE
NASHVILLE TN
37205-2422
US

V. Phone/Fax

Practice location:
  • Phone: 615-573-8069
  • Fax: 615-333-0676
Mailing address:
  • Phone: 615-496-3483
  • Fax: 615-385-1676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP002569
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number32279
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: