Healthcare Provider Details

I. General information

NPI: 1023677358
Provider Name (Legal Business Name): TANESHIA MCCLENDON DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANESHIA LEVERETT DNP, APRN, FNP-C

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 7TH ST W
PALMETTO FL
34221-5209
US

IV. Provider business mailing address

PO BOX 1000
MEMPHIS TN
38148-5203
US

V. Phone/Fax

Practice location:
  • Phone: 941-300-4440
  • Fax: 877-651-1335
Mailing address:
  • Phone: 941-300-4440
  • Fax: 941-404-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11002685
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11002685
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: