MEDICARE: MRS. LEANNE CULLOM APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	18393	TN

General Provider Information

NPI Number	:	1073937660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEANNE CULLOM APRN, FNP-C

Provider Business Mailing Address
First Line	:	4006 PILGRIM TRL
Second Line	:
City	:	GREENBRIER
State	:	TN
Zip	:	37073-5038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 HAYES ST STE 545
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2655
Country	:	US
Telephone Number	:	629-401-4494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	11/12/2025

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