Individual
MR. LESLIE A. MATHEWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN (PMHNP)
Contact information
Practice address
10434 JACKSON OAKS WAY, KNOXVILLE, TN 37922-3293
(865) 281-1408
Mailing address
10434 JACKSON OAKS WAY, KNOXVILLE, TN 37922-3293
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
142095
TN
363L00000X
Nurse Practitioner
25390
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10492
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3648105
MEDICARE ID TYPE UNSPECIFIED
TN
Enumeration date
06/17/2006
Last updated
06/28/2023
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