Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MD36693 | TN |
Y | 207RP1001X | Pulmonary Disease | MD36693 | TN |
NPI | 1043300288 |
---|---|
Provider Name | Dr. Elisabeth Donlevy Willers |
First Address | Nashville, TN 37232-5100 |
Second Address | Nashville, TN 37232-5100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 14/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3826836 | (05) | TN |
6047484 | BCBST (01) | TN |
BD7902580 | DEA (01) |