Provider Demographics
NPI:1053408567
Name:LESSLY, JEAN RAINES (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:RAINES
Last Name:LESSLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1836 CROMWELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215
Mailing Address - Country:US
Mailing Address - Phone:615-767-7507
Mailing Address - Fax:615-309-9982
Practice Address - Street 1:1836 CROMWELL DRIVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-767-7507
Practice Address - Fax:615-309-9982
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN3875485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH66188Medicare UPIN