Marcile Helen Leaf, FNP-C
Individual provider Active NPI Family Nurse Practitioner · East Ridge, TN
NPI 1154480986 · NPPES record last updated Oct 16, 2013
Key facts
- NPI
- 1154480986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 06960 (TN)
- Practice address
- 1508 Tombras Ave
East Ridge, TN 37412-2720 - Phone
- (423) 867-4969
- Fax
- (423) 867-4971
- NPI assigned
- Dec 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6960 | TN | MD | Physician Assistant |
| 06960 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthforce Corporation | Past | Accepting new patients | |
| Trilogy Integrated Health Care, Inc. of Georgia | Past | Accepting new patients | |
| Trilogy Integrated Health Care, Inc. of Georgia | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 06960 | TN | Yes |
Addresses
Primary practice location
1508 Tombras Ave
East Ridge, TN 37412-2720
Mailing address
1508 Tombras Ave
East Ridge, TN 37412-2720
Phone (423) 867-4969
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4332149 | Other | TN | BCBS - TENNESSEE |
| 1519108 | Medicaid | TN |
Other providers in East Ridge, TN
- Marie Anne Kamrath
- Christina Eunan Kang
- Khodiyar Health LLC
- Joan Elizabeth Kramer
- Amy Dawn Latham
- Life Care Centers of America, Inc.
- Mary Christy Lipscomb
- Tami Lyn Lloyd
- Caroline A Lolay
- Loving Hands Caregiver
All providers in East Ridge, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.