Provider Demographics
NPI:1518019652
Name:AUSTIN, LAURIE LEIGH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:LEIGH
Last Name:AUSTIN
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 1:355 SNOW FARM RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERN
Mailing Address - State:TN
Mailing Address - Zip Code:38059
Mailing Address - Country:US
Mailing Address - Phone:731-627-9922
Mailing Address - Fax:
Practice Address - Street 1:1755 PARR AVENUE
Practice Address - Street 2:DYER COUNTY HEALTH DEPARTMENT
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-285-7311
Practice Address - Fax:731-286-2527
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000011868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000011868OtherLICENSE
TN0000011868OtherLICENSE