MEDICARE: MRS. LESA KAY PALERINO FNP-C, APRN, BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN077219 NP	GA

General Provider Information

NPI Number	:	1851475107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LESA KAY PALERINO FNP-C, APRN, BC

Provider Business Mailing Address
First Line	:	7141 MOON RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	GA
Zip	:	31909-7294
Country	:	US
Telephone Number	:	706-289-1393
Fax Number	:	706-257-9993

Provider Business Practice Location Address
First Line	:	7141 MOON RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	GA
Zip	:	31909-7294
Country	:	US
Telephone Number	:	706-289-1393
Fax Number	:	706-257-9993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/09/2014

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