Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 18139 | TN |
NPI | 1083037279 |
---|---|
Provider Name | Laura C Wasielewski |
First Address | Nashville, TN 37203-6532 |
Second Address | Westmoreland, TN 37186-3251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2014 |
Last Update Date | 04/01/2022 |