Provider Demographics
NPI:1780944405
Name:SUKOWATEY, LENA LEE (APN)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:LEE
Last Name:SUKOWATEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:LENA
Other - Middle Name:LEE
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-385-3704
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner