Individual
LESLEY ROBINSON VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4909 GREAT RIVER DRIVE, MERIDIAN, MS 39305-2664
(601) 282-8980
(601) 693-6561
Mailing address
225 DUNN ST, HOUMA, LA 70360-4413
(985) 872-5864
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R868254
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01139881
—
MS
01
—
731-05568
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
04/21/2009
Last updated
06/22/2018
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