Individual
LESA FERRELL WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
109 NORTH FRONT ST., SANDERSVILLE, MS 39477-0001
(601) 426-7603
(601) 426-1087
Mailing address
PO BOX 1649, LAUREL, MS 39441-1649
(601) 399-6158
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R781266
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R781266
BOARD OF NURSING LICENSE
MI
Enumeration date
05/31/2006
Last updated
10/12/2012
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