Provider Demographics
NPI:1871839878
Name:BAUMSTARK, ELIZABETH A (APN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BAUMSTARK
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1534
Mailing Address - Country:US
Mailing Address - Phone:615-342-6010
Mailing Address - Fax:615-342-7898
Practice Address - Street 1:330 23RD AVE N
Practice Address - Street 2:SUITE 300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1534
Practice Address - Country:US
Practice Address - Phone:615-342-6010
Practice Address - Fax:615-342-7898
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN17165OtherAPN LICENSE