Healthcare Provider Details

I. General information

NPI: 1205401874
Provider Name (Legal Business Name): LEIGHTON NORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 MEDICAL CENTER PKWY STE 300
MURFREESBORO TN
37129-2250
US

IV. Provider business mailing address

820 SPRINGER DR
LOMBARD IL
60148-6413
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-4100
  • Fax:
Mailing address:
  • Phone: 815-744-8554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number29471
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: