Basic Information
| Provider Information | |||||||||
| NPI: | 1649787888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DASCHNER | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N STE 403 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372035180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152847261 | ||||||||
| FaxNumber: | 6152847501 | ||||||||
| Practice Location | |||||||||
| Address1: | 108 PROVIDENCE TRL | ||||||||
| Address2: | |||||||||
| City: | MT JULIET | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154660041 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2018 | ||||||||
| LastUpdateDate: | 08/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 3453 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.