Individual
MISS EMILY LYNN WIDELOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3443 DICKERSON PIKE STE 190, NASHVILLE, TN 37207-2533
(615) 860-1580
Mailing address
228 HILLSIDE RD, OAK RIDGE, TN 37830-5044
(615) 519-5213
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3960
TN
Other
Enumeration date
01/07/2020
Last updated
01/28/2021
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