Provider Demographics
NPI:1720263213
Name:HELLER, LESLIE ANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANNE
Last Name:HELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7730 DANNAHER DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4039
Mailing Address - Country:US
Mailing Address - Phone:865-524-7107
Mailing Address - Fax:865-524-3709
Practice Address - Street 1:7730 DANNAHER DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4039
Practice Address - Country:US
Practice Address - Phone:865-524-7107
Practice Address - Fax:865-524-3709
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN1560363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical