Provider Demographics
NPI:1477711612
Name:BROGDON, ELIZABETH MATTHEWS (MSN APN NNP BC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MATTHEWS
Last Name:BROGDON
Suffix:
Gender:F
Credentials:MSN APN NNP BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6200 WILLOW OAK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3988
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1538
Practice Address - Country:US
Practice Address - Phone:615-342-4660
Practice Address - Fax:615-342-4662
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN11890363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal