Lesley K Davidson, RN

Individual provider Active NPI Registered Nurse · Fayetteville, TN

NPI 1376731364 · NPPES record last updated Oct 4, 2007

Key facts

NPI
1376731364
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN0000141418 (TN)
Practice address
1000 Washington St W Ste a
Fayetteville, TN 37334-2872
Phone
(931) 433-3231
Fax
(931) 438-1567
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000141418TNMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN0000141418 TN Yes

Addresses

Primary practice location

1000 Washington St W Ste a
Fayetteville, TN 37334-2872

Mailing address

1000 Washington St W Ste a
Fayetteville, TN 37334-2872
Phone (931) 433-3231

Other providers in Fayetteville, TN

All providers in Fayetteville, TN · Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.