Provider Demographics
NPI:1194216994
Name:PARTLOW, LESLIE KAREN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:KAREN
Last Name:PARTLOW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:KAREN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6605
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75711-6605
Mailing Address - Country:US
Mailing Address - Phone:903-592-6000
Mailing Address - Fax:903-592-3224
Practice Address - Street 1:2737 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-5413
Practice Address - Country:US
Practice Address - Phone:903-592-6000
Practice Address - Fax:903-592-3224
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137549363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty