Healthcare Provider Details

I. General information

NPI: 1538667498
Provider Name (Legal Business Name): LESLIE COOPER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 BOYDS BRIDGE PIKE
KNOXVILLE TN
37914-6233
US

IV. Provider business mailing address

2717 E OAKLAND AVE
JOHNSON CITY TN
37601-1843
US

V. Phone/Fax

Practice location:
  • Phone: 423-926-2358
  • Fax: 423-926-2680
Mailing address:
  • Phone: 423-926-2358
  • Fax: 423-926-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0024175787
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33201
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: