Individual
MS. LESLIE AMANDA LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-8140
(907) 228-8440
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1146
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022353
—
AK
Enumeration date
06/11/2010
Last updated
03/21/2019
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