Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 36717 | SC |
N | 111NI0900X | Internist | 36717 | SC |
N | 207RH0002X | Hospice and Palliative Medicine | 36717 | SC |
Y | 207RH0002X | Hospice and Palliative Medicine | 48458 | TN |
NPI | 1063738219 |
---|---|
Provider Name | Maribeth Hamrick Bosshardt |
First Address | Nashville, TN 37244 |
Second Address | Chattanooga, TN 37404-1130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2010 |
Last Update Date | 05/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q033728 | (05) | TN |