Individual
LESLEY D. GOULDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
775 POLE LINE RD W STE 302, TWIN FALLS, ID 83301-5823
(208) 814-8740
(208) 814-8955
Mailing address
PO BOX 25, CHESTER, ID 83421-0025
(208) 390-1923
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
55516
ID
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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