Provider Demographics
NPI:1346616257
Name:SMITH, LESLEY F (NP)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:F
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 123535
Mailing Address - Street 2:3535
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-3535
Mailing Address - Country:US
Mailing Address - Phone:855-686-8430
Mailing Address - Fax:904-265-8181
Practice Address - Street 1:1202 S TYLER ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2330
Practice Address - Country:US
Practice Address - Phone:985-898-4000
Practice Address - Fax:904-265-8181
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP08419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner