Provider Demographics
NPI:1598372047
Name:LUNCEFORD-LEVESQUE, MARY KATHRYN (PA-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:LUNCEFORD-LEVESQUE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:700 OLD HICKORY BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5462
Mailing Address - Country:US
Mailing Address - Phone:615-454-6290
Mailing Address - Fax:629-200-0999
Practice Address - Street 1:700 OLD HICKORY BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5462
Practice Address - Country:US
Practice Address - Phone:615-454-6290
Practice Address - Fax:629-200-0999
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2023-04-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical