Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 2688 | TN |
N | 208000000X | Pediatrician | IN PROCESS | OH |
NPI | 1235381922 |
---|---|
Provider Name | Leslie Burton |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2008 |
Last Update Date | 15/10/2020 |