Individual
ELIZABETH P DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1620 WESTGATE CIR, BRENTWOOD, TN 37027-8035
(629) 255-2095
(629) 255-4107
Mailing address
222 22ND AVE N, NASHVILLE, TN 37203-1852
(629) 255-3486
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35225
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1502891
—
TN
Enumeration date
09/07/2005
Last updated
12/20/2024
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