Provider Demographics
NPI:1174866461
Name:ISAACS, LESLIE L (RN)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:L
Last Name:ISAACS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LESLIE
Other - Middle Name:L
Other - Last Name:LETSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:202 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-5711
Mailing Address - Country:US
Mailing Address - Phone:877-696-8773
Mailing Address - Fax:
Practice Address - Street 1:9846 HWY 31 E
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75705-2329
Practice Address - Country:US
Practice Address - Phone:903-592-8001
Practice Address - Fax:903-581-1879
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX768774163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health