Leake, Melissa O

Leake, Melissa O is an individual health care provider with primary practice located at 301 Med Tech Pkwy Suite 240, Johnson City TN 37604-2364. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Leake, Melissa O can be contacted via phone (423) 794-5520.

Contact Information

Primary practice address
301 Med Tech Pkwy Suite 240 Johnson City TN 37604-2364
Phone: (423) 794-5520
Fax: (423) 282-0720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 6483 Tennessee

Profile Details

NPI number 1740285915
LBN Legal business name Leake, Melissa O
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Apr 28th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740285915 NPPES
Tennessee MEDICAID 3905935

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