Basic Information
| Provider Information | |||||||||
| NPI: | 1174958714 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURKE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | HUDSON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DNP, APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 24TH AVE SOUTH | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153274751 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158676000 | ||||||||
| FaxNumber: | 6152255381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2013 | ||||||||
| LastUpdateDate: | 12/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 190091 | TN | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | 18058 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.