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General NPI Number Information
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NPI Number | 1225512635
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Entity Type | Individual
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Provider Name | STEFANIE RENEE LESLEY APRN
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 1812 PLEASANT GROVE RD STE B
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City | JONESBORO
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State | AR
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Zip | 72405-7870
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Country | US
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Telephone | 870-898-0088
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Fax | 800-894-8806
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Provider Business Mailing Address
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Address Line | 1812 PLEASANT GROVE RD STE B
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City | JONESBORO
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State | AR
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Zip | 72405-7870
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Country | US
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Telephone | 870-898-0088
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Fax | 800-894-8806
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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 | A005905
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License Number State | AR
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