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General NPI Number Information
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NPI Number | 1619290749
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Entity Type | Individual
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Provider Name | PEGGY KERRES LEONARD CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 200 STONECREST BLVD
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City | SMYRNA
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State | TN
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Zip | 37167-6810
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Country | US
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Telephone | 615-768-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 LEEVILLE RD
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City | MT JULIET
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State | TN
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Zip | 37122-3910
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Country | US
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Telephone | 865-368-7070
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 082939
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License Number State | OH
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