Provider Demographics
NPI:1003157181
Name:ROSSLEY, LESLIE ANN (ARNP, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:ROSSLEY
Suffix:
Gender:F
Credentials:ARNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E REDSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5348
Mailing Address - Country:US
Mailing Address - Phone:850-689-0555
Mailing Address - Fax:
Practice Address - Street 1:160 E REDSTONE AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5348
Practice Address - Country:US
Practice Address - Phone:850-689-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9351849363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics