Provider Demographics
NPI:1083706394
Name:LEFLORE, JUDITH LYNN (PHD, RN, NNP, CPNP)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:LYNN
Last Name:LEFLORE
Suffix:
Gender:F
Credentials:PHD, RN, NNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6908 LLOYD VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3129
Mailing Address - Country:US
Mailing Address - Phone:214-987-4085
Mailing Address - Fax:817-272-5006
Practice Address - Street 1:1935 MOTOR ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX537512163WP0200X
TX20041208363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WP0200XNursing Service ProvidersRegistered NursePediatrics