Individual
LEZLIE MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1391 BROAD AVE, GULFPORT, MS 39501-2419
(228) 863-8868
(228) 396-3830
Mailing address
1391 BROAD AVE, STE A, GULFPORT, MS 39501-2419
(228) 392-7429
(228) 396-3830
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R830483
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00153898
—
MS
Enumeration date
10/10/2006
Last updated
01/18/2018
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