Individual
TAMARA ALICIA LESURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6355 NESTING DOVE, OLIVE BRANCH, MS 38654-4700
(662) 812-7685
Mailing address
6355 NESTING DOVE, OLIVE BRANCH, MS 38654-4700
(662) 812-7685
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
TN
376K00000X
Nurse's Aide
89655
TN
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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