LESLIE LEEANN ELLIS FNP NPI 1790063212

NPI Information

NPI: 1790063212
Provider Name: LESLIE LEEANN ELLIS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
150 OAK MANOR RD
MC KENZIE, TN
ZIP 38201
Phone: (731) 394-1145
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Leslie Leeann Ellis, FNP is a family nurse practitioner in Mc Kenzie, TN with 13 years of experience. Leslie Leeann Ellis, FNP NPI is 1790063212. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

150 OAK MANOR RD
MC KENZIE, TN
ZIP 38201-846
Phone: (731) 394-1145

The NPI 1790063212 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/1/2011 and was last updated on 4/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		APN0000015946	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	3013613	KENTUCKY	No
3	363LF0000X	Nurse Practitioner	Family	15946	TENNESSEE	No
4	363LF0000X	Nurse Practitioner	Family	APN0000015946	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1529449	MEDICAID	TENNESSEE
2	7100209750	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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