Healthcare Provider Details

I. General information

NPI: 1538035860
Provider Name (Legal Business Name): ELIZABETH WUNDERLICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-0004
US

IV. Provider business mailing address

5008A MICHIGAN AVE
NASHVILLE TN
37209-2228
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax: 615-322-5000
Mailing address:
  • Phone: 901-647-4767
  • Fax: 901-647-4767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: