Provider Demographics
NPI:1265204960
Name:LESLIE E ENGLAND
Entity type:Organization
Organization Name:LESLIE E ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONERLY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:601-442-9802
Mailing Address - Street 1:151 JEFFERSON DAVIS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5140
Mailing Address - Country:US
Mailing Address - Phone:601-442-9802
Mailing Address - Fax:601-442-5802
Practice Address - Street 1:151 JEFFERSON DAVIS BLVD STE C
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5140
Practice Address - Country:US
Practice Address - Phone:601-442-9802
Practice Address - Fax:601-442-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty