| Doctor Name: | LESA FERRELL WATERS |
| NPI Number: | 1316984230 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R781266 |
| Business Practice Address: | 109 North Front St. Sandersville, MS - 394770001 |
| Business Phone Number: | 6014267603 |
| Business Fax Number: | 6014261087 |
| Mailing Address: | Po Box 1649, LAUREL |
| State: | MS |
| Postal Code: | 394411649 |
| Phone Number: | 6013996158 |
| Fax Number: | 6013996281 |
| NPI Enumeration Date: | 05/31/2006 |
| NPI Last Update Date: | 10/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | R781266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |