Doctor Name: | MRS. LESLIE POLK VAN DYKE |
NPI Number: | 1124023916 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 53-45551-051 |
Business Practice Address: | 1658 W Grande Blvd Ste 100 Tyler, TX - 757034426 |
Business Phone Number: | 9036176239 |
Business Fax Number: | 9036176249 |
Mailing Address: | 19836 Post Oak Bnd, LINDALE |
State: | TX |
Postal Code: | 757713621 |
Phone Number: | 9035043376 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2005 |
NPI Last Update Date: | 09/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163W00000X |
License Number: | 53-45551-051 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N. |