Provider Demographics
NPI:1538231055
Name:MAXEN, ELIZABETH LOUISE (MSN, CFNP, CNM)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:MAXEN
Suffix:
Gender:F
Credentials:MSN, CFNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W MEADE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3164
Mailing Address - Country:US
Mailing Address - Phone:615-352-5738
Mailing Address - Fax:
Practice Address - Street 1:METRO PUBLIC HEALTH DEPARTMENT
Practice Address - Street 2:311 - 23RD AVENUE NORTH, ROOM 116
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-340-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN93909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse