Provider Demographics
NPI:1578654422
Name:LEUSCHEN, CARLA DAWN (MSN, CNS, FNP, RN)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:DAWN
Last Name:LEUSCHEN
Suffix:
Gender:F
Credentials:MSN, CNS, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 LEBANON RD
Mailing Address - Street 2:ATTN: FIRM B
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1237
Mailing Address - Country:US
Mailing Address - Phone:615-225-4830
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:MEDICAL SVC/PRIMARY CARE-111
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-867-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515308363LF0000X
CA1857364SA2200X
TNAPN0000012826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000012826OtherCERTIFICATE OF FITNESS
CA14750OtherNURSE PRACTITIONER FURNIS