Provider Demographics
NPI:1366796054
Name:PFEFFER, EMILY WELTON (NP-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:WELTON
Last Name:PFEFFER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 ALTHORP WAY
Mailing Address - Street 2:UNIT W2
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7085
Mailing Address - Country:US
Mailing Address - Phone:615-440-6614
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-440-6614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530406Medicaid