Provider Demographics
NPI:1992803753
Name:MCINNIS, LEIGH ANN (PHD)
Entity type:Individual
Prefix:MS
First Name:LEIGH ANN
Middle Name:
Last Name:MCINNIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:LEIGH ANN
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:745 S CHURCH ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4984
Mailing Address - Country:US
Mailing Address - Phone:615-893-9390
Mailing Address - Fax:615-893-4162
Practice Address - Street 1:745 S CHURCH ST
Practice Address - Street 2:SUITE 601
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4984
Practice Address - Country:US
Practice Address - Phone:615-893-9390
Practice Address - Fax:615-893-4162
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 6196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily