Dykstra, Elizabeth P
Dykstra, Elizabeth P is an individual health care provider with primary practice located at 1622 Westgate Cir , Brentwood TN 37027-8019. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dykstra, Elizabeth P can be contacted via phone (629) 255-2095.Contact Information
Primary practice address
1622 Westgate Cir
Brentwood TN 37027-8019
Phone: (629) 255-2095
Fax: (629) 255-4107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35225 | Tennessee |
Profile Details
| NPI number | 1659365518 |
|---|---|
| LBN Legal business name | Dykstra, Elizabeth P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Feb 21st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659365518 | NPPES |
| Tennessee | MEDICAID | 1502891 |
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