Healthcare Provider Details

I. General information

NPI: 1902747637
Provider Name (Legal Business Name): WRENN ELIZABETH WICKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 PIERCE AVE
NASHVILLE TN
37232-0025
US

IV. Provider business mailing address

2311 PIERCE AVE
NASHVILLE TN
37232-0025
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number3996
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: