Basic Information
| Provider Information | |||||||||
| NPI: | 1326354739 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | AMBER | ||||||||
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| Credential: | APN, DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 CAMDEN CUTOFF RD | ||||||||
| Address2: | |||||||||
| City: | PINE BLUFF | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716039199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705106467 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4747 DUSTY LAKE DR | ||||||||
| Address2: | SUITE G1 | ||||||||
| City: | PINE BLUFF | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716038742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705366600 | ||||||||
| FaxNumber: | 8705418623 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2010 | ||||||||
| LastUpdateDate: | 08/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A03430. | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.