Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 290107 | NC |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 290107 | NC |
N | 363LP0200X | Nurse Practitioner - Pediatrics | RN237918 | GA |
NPI | 1033521133 |
---|---|
Provider Name | Ms. Leslie Franks Thompson |
First Address | Gastonia, NC 28054-2140 |
Second Address | Gastonia, NC 28054-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 26/10/2020 |