Provider Demographics
NPI:1255697447
Name:DOEPKER, LESLIE VICTORIA (ARNP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:VICTORIA
Last Name:DOEPKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:VICTORIA
Other - Last Name:WOOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-891-5244
Practice Address - Street 1:9161 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1438
Practice Address - Country:US
Practice Address - Phone:865-694-2900
Practice Address - Fax:865-694-2901
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9255764363LF0000X
TN30165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0N37OtherBCBS FL
TN30165OtherTN APRN