Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 20711 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 20711 | TN |
N | 363LG0600X | Nurse Practitioner - Gerontology | 20711 | TN |
NPI | 1235502857 |
---|---|
Provider Name | Tyler Wolz |
First Address | Nashville, TN 37209-4518 |
Second Address | Nashville, TN 37232-0004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2015 |
Last Update Date | 20/12/2021 |