Provider Demographics
NPI:1982840286
Name:THOMISEE LEASURE, KAREN ELLEN (PNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELLEN
Last Name:THOMISEE LEASURE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ELLEN
Other - Last Name:THOMISEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:PO BOX 1347
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-1347
Mailing Address - Country:US
Mailing Address - Phone:828-328-1118
Mailing Address - Fax:828-328-1119
Practice Address - Street 1:3411 GRAYSTONE PL SE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8200
Practice Address - Country:US
Practice Address - Phone:828-328-1118
Practice Address - Fax:828-328-1119
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004892363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics