Provider Demographics
NPI:1386990299
Name:LANDY, LEIGH ANN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
Last Name:LANDY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANN
Other - Last Name:WEATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:777 W POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2592
Mailing Address - Country:US
Mailing Address - Phone:901-221-7175
Mailing Address - Fax:901-221-7913
Practice Address - Street 1:777 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2592
Practice Address - Country:US
Practice Address - Phone:901-221-7175
Practice Address - Fax:901-221-7913
Is Sole Proprietor?:No
Enumeration Date:2012-07-29
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867660363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care