Provider Demographics
NPI:1235504994
Name:PRICE, LESLIE MILLER (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MILLER
Last Name:PRICE
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71777 SAN JACINTO DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4457
Mailing Address - Country:US
Mailing Address - Phone:888-743-7526
Mailing Address - Fax:
Practice Address - Street 1:71777 SAN JACINTO DR
Practice Address - Street 2:SUITE 202
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4457
Practice Address - Country:US
Practice Address - Phone:888-743-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003539363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health