Provider Demographics
NPI:1104364090
Name:GARRETT, LESLIE K (NP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:K
Last Name:GARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:K
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9000 EXECUTIVE PARK DR STE C200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4644
Mailing Address - Country:US
Mailing Address - Phone:865-670-6700
Mailing Address - Fax:865-305-8769
Practice Address - Street 1:1924 ALCOA HWY # U56
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9081
Practice Address - Fax:865-305-8769
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily