Provider Demographics
NPI:1962956987
Name:MUGNANO, ELIZABETH (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:MUGNANO
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 LITTLE LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-2953
Mailing Address - Country:US
Mailing Address - Phone:615-504-8954
Mailing Address - Fax:
Practice Address - Street 1:9020 OVERLOOK BLVD STE 130
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3259
Practice Address - Country:US
Practice Address - Phone:865-219-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000208657163W00000X
TN208657163W00000X
TN21905363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse