Provider Demographics
NPI:1316291578
Name:RADISH, ELISABETH BEALE (CPNP PC)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:BEALE
Last Name:RADISH
Suffix:
Gender:F
Credentials:CPNP PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 N PARRISH PL STE 2000
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1004
Mailing Address - Country:US
Mailing Address - Phone:615-826-2080
Mailing Address - Fax:615-822-3213
Practice Address - Street 1:410 N PARRISH PL STE 2000
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1004
Practice Address - Country:US
Practice Address - Phone:615-826-2080
Practice Address - Fax:615-822-3213
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17106363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN184290OtherREGISTERED NURSE
TN17106OtherNURSE PRACTITIONER
TN20122365OtherBORD CERTIFIED