Organization
LUCENA 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DESHA FNP (NURSE PRACTITIONER)
(573) 690-3976
Entity
Organization
Contact information
Practice address
1000 W NIFONG BLVD BLDG 2, SUITE 120 ROOM 2, COLUMBIA, MO 65203-5615
(573) 444-6331
Mailing address
1109 PHEASANT RUN, COLUMBIA, MO 65201-6253
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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