Provider Demographics
NPI:1083167142
Name:EDWARDS, LESLEE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LESLEE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:LESLEE
Other - Middle Name:MICHELLE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5124 SE 81ST TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-6336
Mailing Address - Country:US
Mailing Address - Phone:405-323-4879
Mailing Address - Fax:
Practice Address - Street 1:5124 SE 81ST TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-6336
Practice Address - Country:US
Practice Address - Phone:405-323-4879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK97213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily