Provider Demographics
NPI:1558875666
Name:WINGFIELD, LESLEY MORGAN (APRN)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:MORGAN
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2257 N GERMANTOWN PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-7412
Mailing Address - Country:US
Mailing Address - Phone:901-922-5425
Mailing Address - Fax:901-842-1473
Practice Address - Street 1:6500 KIRBY GATE BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-2673
Practice Address - Country:US
Practice Address - Phone:901-842-1473
Practice Address - Fax:901-844-1439
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily