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General NPI Number Information
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NPI Number | 1043873987
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Entity Type | Individual
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Provider Name | LESLIE BROOK TZEN NP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 141 S MACON ST
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City | JESUP
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State | GA
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Zip | 31545-1114
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Country | US
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Telephone | 912-427-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 203 GENERAL STEWART WAY
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City | HINESVILLE
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State | GA
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Zip | 31313-2422
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Country | US
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Telephone | 912-332-4525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN261296
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License Number State | GA
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