Healthcare Provider Details

I. General information

NPI: 1164841821
Provider Name (Legal Business Name): LESLYE WILLIAMS SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 8242
CHATTANOOGA TN
37414-0242
US

IV. Provider business mailing address

PO BOX 8242
CHATTANOOGA TN
37414-0242
US

V. Phone/Fax

Practice location:
  • Phone: 615-207-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number244335
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number79341
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: