=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386015931
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LESLIE W FOSHIE FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2015
-----------------------------------------------------
Last Update Date | 09/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1140 TUSCULUM BLVD
-----------------------------------------------------
City | GREENEVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37745-4039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-525-5462
-----------------------------------------------------
Fax | 423-525-5232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1140 TUSCULUM BLVD
-----------------------------------------------------
City | GREENEVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37745-4039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-525-5462
-----------------------------------------------------
Fax | 423-525-5232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 20322
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------