Individual
KIRSTIE LESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5214
(601) 984-2292
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R885978
MS
363LF0000X
Family Nurse Practitioner
Primary
R885978
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05923555
—
MS
Enumeration date
09/20/2015
Last updated
01/08/2016
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