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General NPI Number Information
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NPI Number | 1205921152
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Entity Type | Individual
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Provider Name | CONNIE S LEANZA CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 1805 N JACKSON ST SUITE 1
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City | TULLAHOMA
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State | TN
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Zip | 37388-2290
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Country | US
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Telephone | 931-222-4083
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Fax | 931-222-4083
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Provider Business Mailing Address
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Address Line | 3024 BUSINESS PARK CIR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3132
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Country | US
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Telephone | 615-239-2018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APN5748
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APN5748
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License Number State | TN
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