Provider Demographics
NPI:1144541905
Name:BANKER, LEAH CONNERS (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:CONNERS
Last Name:BANKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:ELIZABETH
Other - Last Name:CONNERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-396-6620
Mailing Address - Fax:615-396-6625
Practice Address - Street 1:1020 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2494
Practice Address - Country:US
Practice Address - Phone:615-396-6620
Practice Address - Fax:615-396-6625
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51893207Q00000X, 207Q00000X
TXBP10037205390200000X
TXP5931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I084539OtherMEDICARE PIN
TNQ009452Medicaid