Provider Demographics
NPI:1326496944
Name:LEON, ASHLEY DIANE (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANE
Last Name:LEON
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 E HIGHWAY 11 E
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-4910
Mailing Address - Country:US
Mailing Address - Phone:865-375-6005
Mailing Address - Fax:865-471-0244
Practice Address - Street 1:1059 E HIGHWAY 11 E
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-4910
Practice Address - Country:US
Practice Address - Phone:865-375-6005
Practice Address - Fax:865-471-0244
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32666363L00000X
TN0000206955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse