MEDICARE: MS. BANJUL LESHEILA COVINGTON F.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN12692	TN

General Provider Information

NPI Number	:	1811155435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BANJUL LESHEILA COVINGTON F.N.P.

Provider Business Mailing Address
First Line	:	131 SAUNDERSVILLE RD
Second Line	:	STE 160
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-8903
Country	:	US
Telephone Number	:	615-824-3737
Fax Number	:	615-452-8545

Provider Business Practice Location Address
First Line	:	6570 STAGE RD
Second Line	:	STE 160
City	:	BARTLETT
State	:	TN
Zip	:	38134-2839
Country	:	US
Telephone Number	:	901-205-0182
Fax Number	:	901-672-8941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	02/02/2016

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