Individual provider · Type 1 NPI
Leslie Lewynell Provost
Occupational Health Nurse Practitioner · Shreveport, LA
NPI number
1700449220
Active
Practice location
510 E Stoner Ave
Shreveport, LA 71101-4243
Mailing address
715 Reeds Reef
Bossier City, LA 71112-9757
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 200771 (LA) |
| Occupational Health Nurse Practitioner Primary | 363LX0106X | 200771 (LA) |
Occupational Health Nurse Practitioner: Definition to come...
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About NPI 1700449220
Leslie Lewynell Provost's National Provider Identifier is 1700449220, issued on Apr 19, 2019. The primary taxonomy on file is Occupational Health Nurse Practitioner (363LX0106X), and the practice location is in Shreveport, LA. The record was last updated on Sep 1, 2023.