Individual
BETHANY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3601 TVC, NASHVILLE, TN 37232-0001
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-3000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10651
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10651
NP LICENSE NUMBER
TN
Enumeration date
01/18/2006
Last updated
03/15/2022
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