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Individual

LESA RICE TILLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
403 MAGAZINE CT, BOSSIER CITY, LA 71111-6263
(228) 365-7568
Mailing address
416 BRIDGEWATER CIR, BENTON, LA 71006-8807
(318) 525-8688

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
139177
LA
163W00000X
Registered Nurse
628349
TX
163W00000X
Registered Nurse
AP07128
LA
367500000X
Certified Registered Nurse Anesthetist
AP07128
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP116957
TX
367500000X
Certified Registered Nurse Anesthetist
RN139177
IN

Other

Enumeration date
03/15/2006
Last updated
03/18/2024
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