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General NPI Number Information
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NPI Number | 1316291578
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Entity Type | Individual
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Provider Name | ELISABETH BEALE RADISH CPNP PC
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 410 N PARRISH PL STE 2000
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1004
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Country | US
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Telephone | 615-826-2080
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Fax | 615-822-3213
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Provider Business Mailing Address
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Address Line | 410 N PARRISH PL STE 2000
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1004
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Country | US
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Telephone | 615-826-2080
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Fax | 615-822-3213
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 17106
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License Number State | TN
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