Provider Demographics
NPI:1104866185
Name:LEONARD, STEPHEN T (NP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:T
Last Name:LEONARD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58704
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-8704
Mailing Address - Country:US
Mailing Address - Phone:615-945-4661
Mailing Address - Fax:
Practice Address - Street 1:670 SHADOWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-945-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4098508OtherBCBS W PARADIGM
TNP00178079OtherRAILROAD MEDICARE W PARADIGM
TN3902813Medicaid
TN4098508OtherBCBS W PARADIGM