Provider Demographics
NPI:1528442688
Name:LEGGETT, DEBORAH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HURT ST
Mailing Address - Street 2:
Mailing Address - City:TREZEVANT
Mailing Address - State:TN
Mailing Address - Zip Code:38258-2505
Mailing Address - Country:US
Mailing Address - Phone:731-207-0323
Mailing Address - Fax:731-240-8065
Practice Address - Street 1:45 HURT ST
Practice Address - Street 2:
Practice Address - City:TREZEVANT
Practice Address - State:TN
Practice Address - Zip Code:38258-2505
Practice Address - Country:US
Practice Address - Phone:731-541-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily