Provider Demographics
NPI:1417482449
Name:SCOTT, ELISE STEPHENSON (MD)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:STEPHENSON
Last Name:SCOTT
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:ELISE
Other - Middle Name:MICHELLE
Other - Last Name:STEPHENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4101 IDAHO AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3678
Mailing Address - Country:US
Mailing Address - Phone:615-819-4613
Mailing Address - Fax:615-235-1327
Practice Address - Street 1:210 25TH AVE N STE 700
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1611
Practice Address - Country:US
Practice Address - Phone:615-819-4613
Practice Address - Fax:615-235-1327
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN622352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty