Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 45671 | TN |
NPI | 1215064852 |
---|---|
Provider Name | Dr. Elizabeth Ann Null |
First Address | Columbia, TN 38401-4659 |
Second Address | Columbia, TN 38401-6436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 11/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3710089 | (05) | TN |