Individual
LESLEY ANN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 GARFIELD ST, TUPELO, MS 38801-6337
(662) 377-6290
(662) 377-6295
Mailing address
607 GARFIELD ST, TUPELO, MS 38801-6337
(662) 377-6290
(662) 377-6295
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R874445
MS
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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