Provider Demographics
NPI:1376170795
Name:LEO, MARY BRITT (RN, CPM)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BRITT
Last Name:LEO
Suffix:
Gender:F
Credentials:RN, CPM
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:LEO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CPM
Mailing Address - Street 1:7153 NOLENSVILLE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9461
Mailing Address - Country:US
Mailing Address - Phone:615-669-9470
Mailing Address - Fax:833-685-0731
Practice Address - Street 1:7153 NOLENSVILLE RD FL 2
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9461
Practice Address - Country:US
Practice Address - Phone:615-669-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife