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General NPI Number Information
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NPI Number | 1205072303
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Entity Type | Organization
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Legal Business Name | CREATIVE HEALTHCARE, PLLC
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Dates
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Enumeration Date | 12/21/2008
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 1836 CROMWELL DR
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City | NASHVILLE
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State | TN
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Zip | 37215-5616
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Country | US
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Telephone | 615-309-9982
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Fax |
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Provider Business Mailing Address
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Address Line | 1836 CROMWELL DR
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City | NASHVILLE
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State | TN
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Zip | 37215-5616
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Country | US
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Telephone | 615-309-9982
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. JEAN RAINES LESSLY
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Credential | M.D.
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Telephone | 615-309-9982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35619
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License Number State | TN
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