Provider Demographics
NPI:1134383276
Name:WHITEFIELD, LESLIE R (APRN)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:R
Last Name:WHITEFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:21019 HIGHWAY 167 STE 200
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-8154
Mailing Address - Country:US
Mailing Address - Phone:501-261-7630
Mailing Address - Fax:501-261-7625
Practice Address - Street 1:21019 HIGHWAY 167 STE 200
Practice Address - Street 2:
Practice Address - City:HENSLEY
Practice Address - State:AR
Practice Address - Zip Code:72065-8154
Practice Address - Country:US
Practice Address - Phone:501-261-0517
Practice Address - Fax:501-261-7625
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA003152363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily