MRS. LEABETH MACON PACK (NPI# 1154747889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154747889 |
| Entity Type | Individual |
| Full Name | MRS. LEABETH MACON PACK |
| Credential | NP-C |
| Practice Address |
1430 W Baddour Pkwy Ste A Lebanon TN 37087-2656 |
| Mailing Address |
1616 W Main St Ste 201 Lebanon TN 37087-3100 |
| Practice Telephone | 6154536144 |
| Mailing Telephone | 6154441180 |
| Mailing Fax Number | 6154496148 |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2017-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
18455 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1430 W BADDOUR PKWY STE A |
| City | LEBANON |
| State | TN |
| Zip Code | 37087-2656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962745356 | Angie C Riddle | Nurse Practitioner | 1430 W Baddour Pkwy Ste A, Lebanon, TN 37087-2656 | 2013-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051698 | Results-ast Jv, LLC | Physical Therapist | 1420 West Baddour Parkway, Suite 102, Lebanon, TN 37087 | 2020-10-19 |
| 1306405725 | Angela Kurtz | Hearing Instrument Specialist | 1430 West Baddour Parkwayste D, Lebanon, TN 37087 | 2019-06-10 |
| 1164926937 | Andrea Christine Morrisett | Physical Therapist | 404 N Castle Heights Ave Ste G, Lebanon, TN 37087 | 2018-03-19 |
| 1942731492 | Rocky Mountain Holdings, LLC | Ambulance | 760d Franklin Rd, Lebanon, TN 37087 | 2017-03-27 |
| 1326409285 | Karina Lawrence | Speech-Language Pathologist | 1006 Keaton Street, Lebanon, TN 37087 | 2016-03-18 |
| 1174910491 | Yehualashet Bekele Hailemariam | Internal Medicine | 1411 W Baddour Pkwy,lebanon Tn 37087, Lebanon, TN 37087 | 2015-04-24 |
| 1043614829 | Jean Thompson | Behavioral Analyst | 1004 Hickory Hill Lane, Suite 2, Hermitage, TN 37087 | 2014-10-22 |
| 1588072771 | La Keisha Fair | Community Health Worker | 1 Cumberland Square, Lebanon, TN 37087 | 2014-07-31 |
| 1023440609 | James Martin Meadows | Specialist/Technologist | One Cumberland Square, Lebanon, TN 37087 | 2013-08-06 |
| 1336571231 | Lori Ann De Leo | Social Worker | 109 Autumn Creek, Lebanon, TN 37087 | 2013-08-01 |
| Find all providers in zip 37087 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
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| 1932716420 | Jessica Erb | Nurse Practitioner | 804 Holly Ln, Lebanon, PA 17042-9028 | 2020-09-28 |
| 1922619527 | Tammy Lynn Whitt | Nurse Practitioner | 961 Poor Farm Rd, Lebanon, VA 24266-7097 | 2020-08-17 |
| 1538777529 | Shenia Diane Johnson | Nurse Practitioner | 71 S. Flannagan Ave., Lebanon, VA 24266-2426 | 2020-07-16 |
| 1275158164 | Kelly Mcdaniel | Nurse Practitioner | 288 Rolling Meadows Rd, Lebanon, VA 24266-5870 | 2020-06-16 |
| 1609498955 | Kelsey Jones | Nurse Practitioner | 1412 Nathaniel Dr, Lebanon, MO 65536-8906 | 2020-05-09 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1205479458 | Natasha Denney Arentz | Nurse Practitioner | 5787 Oh-63, Lebanon, OH 45036 | 2019-10-21 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1821642430 | Jill Montgomery Major | Nurse Practitioner | 135 Knights Brg, Lebanon, TN 37090-1410 | 2019-07-31 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.