Healthcare Provider Details

I. General information

NPI: 1265897508
Provider Name (Legal Business Name): MEGAN ELIZABETH WILKEY RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 14TH AVE N
NASHVILLE TN
37208-3050
US

IV. Provider business mailing address

1019 STAINBACK AVE
NASHVILLE TN
37207-5719
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-9400
  • Fax:
Mailing address:
  • Phone: 615-419-7864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number8541
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: