Provider Demographics
NPI:1487041521
Name:WOLFE, ELIZABETH CLAIRE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 PATTERSON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6521
Mailing Address - Country:US
Mailing Address - Phone:615-342-4912
Mailing Address - Fax:615-342-4913
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:615-342-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002324363LG0600X
TN24873363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB245187OtherMEDICARE ID