Leslie Michelle Dodd

Individual provider Active NPI Licensed Practical Nurse · Corning, AR

NPI 1780182295 · NPPES record last updated Jan 30, 2018

Key facts

NPI
1780182295
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L055394 (AR)
Practice address
602 David St
Corning, AR 72422-7268
Phone
(870) 857-3655
Fax
(870) 857-3667
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L055394ARMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L055394 AR Yes

Addresses

Primary practice location

602 David St
Corning, AR 72422-7268

Mailing address

2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4961

Other providers in Corning, AR

All providers in Corning, AR · Licensed Practical Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.