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General NPI Number Information
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NPI Number | 1053740753
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Entity Type | Individual
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Provider Name | JOE LAWRENCE SLEDGE RN FNP
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Gender | Male
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 1631 11TH ST STE A
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4320
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Country | US
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Telephone | 940-624-3222
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Fax | 940-264-3225
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Provider Business Mailing Address
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Address Line | 1631 11TH ST STE A
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4320
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Country | US
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Telephone | 940-624-3222
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Fax | 940-264-3225
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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 | 653463
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License Number State | TX
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