Provider Demographics
NPI:1053753541
Name:LESUEUR, JESSICA J (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:J
Last Name:LESUEUR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEE
Other - Last Name:JARVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:341 COOL SPRINGS BLVD.
Mailing Address - Street 2:STE. 400
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:423-508-7337
Mailing Address - Fax:423-508-7338
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:STE. 240
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2522
Practice Address - Country:US
Practice Address - Phone:615-217-3321
Practice Address - Fax:615-217-3477
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3212152W00000X
KY1923DT152W00000X
TNOD3212152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ009232Medicaid
TNQ009232Medicaid