Provider Demographics
NPI:1174028617
Name:ECHOLS, LESLIE ANN (APRN)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W CHARLESTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1256
Mailing Address - Country:US
Mailing Address - Phone:702-877-9514
Mailing Address - Fax:702-312-3510
Practice Address - Street 1:5701 W CHARLESTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1256
Practice Address - Country:US
Practice Address - Phone:702-877-9514
Practice Address - Fax:702-312-3510
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1174028617Medicaid
NVAPRN002591OtherNV LICENSE