Provider Demographics
NPI:1124249131
Name:KERN, LESLEE MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LESLEE
Middle Name:MARIE
Last Name:KERN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LESLEE
Other - Middle Name:MARIE
Other - Last Name:LUCAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:821 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4615
Mailing Address - Country:US
Mailing Address - Phone:580-255-6292
Mailing Address - Fax:580-255-6293
Practice Address - Street 1:3117 N HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-9283
Practice Address - Country:US
Practice Address - Phone:580-252-0140
Practice Address - Fax:580-252-0143
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
TX43340183500000X
OK136181835G0303X, 1835N1003X, 208U00000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No174H00000XOther Service ProvidersHealth Educator
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology