Provider Demographics
NPI:1316432792
Name:WILLERT, ANN ELIZABETH (MED, NCC)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:ELIZABETH
Last Name:WILLERT
Suffix:
Gender:F
Credentials:MED, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 VANTAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1513
Mailing Address - Country:US
Mailing Address - Phone:615-463-6610
Mailing Address - Fax:
Practice Address - Street 1:322 SUMNER HALL DRIVE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066
Practice Address - Country:US
Practice Address - Phone:615-460-4500
Practice Address - Fax:615-460-4502
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health