Provider Demographics
NPI:1083878862
Name:FERRELL, LESLIE ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:250 SMALL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-3319
Mailing Address - Country:US
Mailing Address - Phone:618-294-8241
Mailing Address - Fax:618-294-8212
Practice Address - Street 1:124 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GALATIA
Practice Address - State:IL
Practice Address - Zip Code:62935-1300
Practice Address - Country:US
Practice Address - Phone:618-268-4083
Practice Address - Fax:618-268-4104
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2008004112363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner