Provider Demographics
NPI:1568715050
Name:KENEMER, ELIZABETH ELLIS (APRN, PMHNP-BC, RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ELLIS
Last Name:KENEMER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC, RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2125 BELCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212
Mailing Address - Country:US
Mailing Address - Phone:615-379-8600
Mailing Address - Fax:615-269-3596
Practice Address - Street 1:2125 BELCOURT AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:910-791-9625
Practice Address - Fax:910-798-8071
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5005894363LP0808X
TN18756363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health