Provider Demographics
NPI:1588446462
Name:MASON, ELIZABETH SUTTON
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUTTON
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 TRACEWAY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4091
Mailing Address - Country:US
Mailing Address - Phone:615-927-1631
Mailing Address - Fax:
Practice Address - Street 1:5129 TRACEWAY DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4091
Practice Address - Country:US
Practice Address - Phone:615-927-1631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer