Provider Demographics
NPI:1952706046
Name:LEONARD, CLINTON DAVID (AG-ACNP)
Entity Type:Individual
Prefix:MR
First Name:CLINTON
Middle Name:DAVID
Last Name:LEONARD
Suffix:
Gender:M
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:
Practice Address - Street 1:1211 MEDICAL CENTERT DR
Practice Address - Street 2:11S BURN UNIT
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-322-4590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162302363LA2100X
TN19332363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology