Provider Demographics
NPI:1376994657
Name:NEW HORIZON DIABETES CLINIC
Entity Type:Organization
Organization Name:NEW HORIZON DIABETES CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSING PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:FERNANDA
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, MBA, ANPBC
Authorized Official - Phone:615-840-7994
Mailing Address - Street 1:390 HARDING PL
Mailing Address - Street 2:ST 102
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3998
Mailing Address - Country:US
Mailing Address - Phone:615-840-7994
Mailing Address - Fax:615-739-6678
Practice Address - Street 1:390 HARDING PL
Practice Address - Street 2:ST 102
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3998
Practice Address - Country:US
Practice Address - Phone:615-840-7994
Practice Address - Fax:615-739-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17240364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty