Provider Demographics
NPI:1316564743
Name:HUGHES, LESLIE K (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:K
Other - Last Name:KETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:104 E SHURDEN INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437-7323
Mailing Address - Country:US
Mailing Address - Phone:918-652-9614
Mailing Address - Fax:918-652-4831
Practice Address - Street 1:104 E SHURDEN INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-7323
Practice Address - Country:US
Practice Address - Phone:918-652-9614
Practice Address - Fax:918-652-4831
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK92398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily