Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP143248 | TX |
NPI | 1003457029 |
---|---|
Provider Name | Mrs. Lesley Lynne Nairn |
First Address | Clute, TX 77531-1489 |
Second Address | Lake Jackson, TX 77566-5211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2019 |
Last Update Date | 01/10/2019 |