Provider Demographics
NPI:1750554945
Name:FAULKNER, LESLIE MARIA (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MARIA
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2265
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70059-2265
Mailing Address - Country:US
Mailing Address - Phone:504-610-3333
Mailing Address - Fax:877-610-3330
Practice Address - Street 1:175 HECTOR AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2590
Practice Address - Country:US
Practice Address - Phone:504-349-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily