Basic Information
| Provider Information | |||||||||
| NPI: | 1659718591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOLAKIS | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ERHARD | ||||||||
| OtherFirstName: | LESLIE | ||||||||
| OtherMiddleName: | D | ||||||||
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| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 410 N CEDAR BLUFF RD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379233632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236983309 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2341 MCCALLIE AVE | ||||||||
| Address2: | SUITE 402 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374043239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236983309 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2013 | ||||||||
| LastUpdateDate: | 12/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | RN 169396 | TN | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 367500000X | 17771 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.