Provider Demographics
NPI:1346983483
Name:FUERSTENAU, ELIZABETH POULOS (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:POULOS
Last Name:FUERSTENAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:POULOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 CHILDRENS WAY STE 2404
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-322-3023
Mailing Address - Fax:615-343-4655
Practice Address - Street 1:2200 CHILDRENS WAY STE 2404
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:615-322-3023
Practice Address - Fax:615-343-4655
Is Sole Proprietor?:No
Enumeration Date:2022-04-17
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program