Laurie Lynette Lehuanani Bagwell, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Lakeland, TN
NPI 1760652127 · NPPES record last updated Apr 16, 2008
Key facts
- NPI
- 1760652127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 13183 (TN)
- Practice address
- 9685 Leeward Slopes Dr
Lakeland, TN 38002-8302 - Phone
- (901) 380-1972
- NPI assigned
- Mar 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 13183 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whiteville Family Medical Clinic, LLC | Family | Past | Accepting new patients |
| T M Carr MD PC | Past | Accepting new patients | |
| Whiteville Medical Clinic, LLC | Family | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13183 | TN | Yes |
Addresses
Primary practice location
9685 Leeward Slopes Dr
Lakeland, TN 38002-8302
Mailing address
9685 Leeward Slopes Dr
Lakeland, TN 38002-8302
Phone (901) 380-1972
Other providers in Lakeland, TN
- Amani Therapy Services LLC
- Emily Grace Bailey
- Diosdado A Barawid Jr.
- Resa Saturday Barawid
- Regina Nichols Barker
- Robert Lee Blackwell III
All providers in Lakeland, 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 Apr 16, 2008. 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.