Provider Demographics
NPI:1013600253
Name:VICTOR, LEILANI HOPE (PA)
Entity type:Individual
Prefix:
First Name:LEILANI
Middle Name:HOPE
Last Name:VICTOR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:333 MURFREESBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-2834
Mailing Address - Country:US
Mailing Address - Phone:615-248-1225
Mailing Address - Fax:
Practice Address - Street 1:607 HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9206
Practice Address - Country:US
Practice Address - Phone:615-616-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6255363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant