Provider Demographics
NPI:1326635947
Name:GILLESPIE, LEZLIE ANN
Entity Type:Individual
Prefix:MRS
First Name:LEZLIE
Middle Name:ANN
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 MALONE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5517
Mailing Address - Country:US
Mailing Address - Phone:937-974-8431
Mailing Address - Fax:
Practice Address - Street 1:929 MALONE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-5517
Practice Address - Country:US
Practice Address - Phone:937-974-8431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care