Individual
LESLIE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
700 W FOREST AVE STE 200, JACKSON, TN 38301-3940
(731) 541-9490
Mailing address
183 UNION AVE, JACKSON, TN 38301-6036
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
25734
TN
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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