Individual
LESLEE EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1507 LINWOOD DR STE A, PARAGOULD, AR 72450-5818
(870) 335-8063
Mailing address
4000 LINWOOD DR STE I, PARAGOULD, AR 72450-7224
(870) 239-8102
(870) 239-8105
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2018-045
MEDICAL LICENSE
AR
Enumeration date
10/23/2018
Last updated
10/24/2019
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