Individual
LEIGH ANN BRANDEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Mailing address
24 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 661-9825
(731) 668-6757
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN0000019241
TN
363LG0600X
Gerontology Nurse Practitioner
APN0000019241
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q011957
—
TN
Enumeration date
10/29/2014
Last updated
11/02/2015
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