Individual
ELEN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3441 DICKERSON PIKE, NASHVILLE, TN 37207-2539
(615) 769-4400
Mailing address
1801 N JACKSON ST, TULLAHOMA, TN 37388-8259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004125
VA
363A00000X
Physician Assistant
085006289
IL
363A00000X
Physician Assistant
Primary
2245
TN
Other
Enumeration date
12/03/2012
Last updated
02/02/2022
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