Provider Demographics
NPI:1386015931
Name:FOSHIE, LESLIE W (FNP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:W
Last Name:FOSHIE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-5401
Mailing Address - Country:US
Mailing Address - Phone:423-636-1521
Mailing Address - Fax:423-636-1523
Practice Address - Street 1:627 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-5401
Practice Address - Country:US
Practice Address - Phone:423-636-1521
Practice Address - Fax:423-636-1523
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1386015931Medicaid
TN1386015931OtherALL OTHER ISSUERS