Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 16426 | TN |
NPI | 1023000999 |
---|---|
Provider Name | Clara R. Womack |
First Address | Nashville, TN 37211-4880 |
Second Address | Nashville, TN 37211-4880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 24/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3046652 | (05) | TN |
E40671 | (02) | TN |