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General NPI Number Information
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NPI Number | 1437498342
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Entity Type | Organization
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Legal Business Name | THE HEALTH TREE LLC
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 16570 HIGHWAY 104 N ST B
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City | LEXINGTON
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State | TN
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Zip | 38351-3876
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Country | US
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Telephone | 731-968-2233
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Fax | 731-968-2275
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Provider Business Mailing Address
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Address Line | 16570 HIGHWAY 104 N ST B
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City | LEXINGTON
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State | TN
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Zip | 38351-3876
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Country | US
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Telephone | 731-968-2233
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Fax | 731-968-2275
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE LEE
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Credential | NP
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Telephone | 731-968-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12374
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License Number State | TN
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