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General NPI Number Information
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NPI Number | 1922568724
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Entity Type | Individual
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Provider Name | FINLEY W LESLIE FNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 1135 BROADWAY ST
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City | SOUTH FULTON
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State | TN
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Zip | 38257-2835
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Country | US
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Telephone | 731-479-2606
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Fax |
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Provider Business Mailing Address
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Address Line | 340 BENJAMIN DR
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City | DYERSBURG
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State | TN
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Zip | 38024-7284
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 25406
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License Number State | TN
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