Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 38186 | TN |
N | 2080P0204X | Pediatric Emergency Doctor | 38186 | TN |
Y | 2080P0205X | Pediatric Endocrinologist | MD0000038186 | TN |
NPI | 1316989965 |
---|---|
Provider Name | Dr. Elizabeth Ann Wirthwein |
First Address | Knoxville, TN 37901-5004 |
Second Address | Knoxville, TN 37916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3336492 | (05) | TN |