Healthcare Provider Details

I. General information

NPI: 1871839878
Provider Name (Legal Business Name): ELIZABETH A BAUMSTARK APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH CARNEY

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 23RD AVE N SUITE 300
NASHVILLE TN
37203-1534
US

IV. Provider business mailing address

330 23RD AVE N SUITE 300
NASHVILLE TN
37203-1534
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-6010
  • Fax: 615-342-7898
Mailing address:
  • Phone: 615-342-6010
  • Fax: 615-342-7898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17165
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: