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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LESLIE LEWYNELL PROVOST

Active

LESLIE LEWYNELL PROVOST is a Occupational Health Nurse Practitioner healthcare provider located in SHREVEPORT, Louisiana. NPI 1700449220 is currently active in the NPPES registry. Verify at CMS.

Occupational Health Nurse Practitioner · SHREVEPORT, LA

Registration Details

NPI Number
1700449220
Provider Type
Individual
Gender
Female
NPI Issued
Apr 19, 2019 (7.3290368805395 yrs)
Last Updated
Sep 1, 2023
Licenses
200771 (LA)
200771 (LA)

Practice Information

Address
510 E STONER AVE
SHREVEPORT, LA, 711014243
Browse LA providers · Browse ZIP 71101
Phone
3182218411
Primary Specialty
Occupational Health Nurse Practitioner
363LX0106X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.