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General NPI Number Information
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NPI Number | 1265579239
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Entity Type | Individual
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Provider Name | WILMA LESLIE FNPC
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 24 LEFT PENHOOK RD
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City | HAROLD
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State | KY
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Zip | 41635-7064
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Country | US
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Telephone | 606-478-8787
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Fax | 606-478-4801
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Provider Business Mailing Address
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Address Line | PO BOX 406
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City | PRESTONSBURG
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State | KY
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Zip | 41653-0406
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Country | US
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Telephone | 606-478-8787
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Fax | 606-478-4801
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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 | 2346P
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3002346
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License Number State | KY
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