Healthcare Provider Details

I. General information

NPI: 1811155435
Provider Name (Legal Business Name): BANJUL LESHEILA COVINGTON F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6570 STAGE RD STE 160
BARTLETT TN
38134-2839
US

IV. Provider business mailing address

131 SAUNDERSVILLE RD STE 160
HENDERSONVILLE TN
37075-8903
US

V. Phone/Fax

Practice location:
  • Phone: 901-205-0182
  • Fax: 901-672-8941
Mailing address:
  • Phone: 615-824-3737
  • Fax: 615-452-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN12692
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: