Individual
LESLI BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14100 PARKWAY COMMONS DR STE 201, OKLAHOMA CITY, OK 73134-6104
(405) 749-2765
(405) 749-6209
Mailing address
14100 PARKWAY COMMONS DR STE 201, OKLAHOMA CITY, OK 73134-6104
(405) 749-2765
(405) 749-6209
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
119449
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112840
—
AL
05
—
1568604197
—
OK
Enumeration date
03/27/2009
Last updated
01/26/2023
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