Healthcare Provider Details

I. General information

NPI: 1053381327
Provider Name (Legal Business Name): LESLIE A PARKER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100187
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100187
GAINESVILLE FL
32610-0187
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6384
  • Fax:
Mailing address:
  • Phone: 352-273-6384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number1651002
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP1651002
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1651002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: