Individual
KATELYN DANIELLE WACKENHUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-6035
(615) 322-5000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3274
TN
363A00000X
Physician Assistant
0110006145
VA
363A00000X
Physician Assistant
Primary
3274
TN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/20/2016
Last updated
01/27/2025
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