Organization
LEARN HEALING BRAIN LLC
Active
Other names
Lea Brainerd, PA-C
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEA HAYLEY BRAINERD PA-C (CEO)
(901) 612-1486
Entity
Organization
Contact information
Practice address
4646 POPLAR AVE STE 409, MEMPHIS, TN 38117-4434
(901) 582-7243
(901) 425-9853
Mailing address
1028 CRESTHAVEN RD STE 200, MEMPHIS, TN 38119-3867
(901) 612-1486
(901) 425-9853
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4706
LICENSE
TN
01
—
PA00599
STATE LICENSE
MS
01
—
PA1099
STATE LICENSE
WY
01
—
TPPA490
STATE LICENSE
FL
01
—
UC-51980AFD-1B01-483
PROFESSIONAL CERTIFIED COACH
—
Enumeration date
11/14/2022
Last updated
09/18/2024
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