Individual
LISA FLEITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1105 EARL FRYE BLVD, AMORY, MS 38821-5500
(662) 256-6090
(662) 257-6760
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901768
MS
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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