Provider Demographics
NPI:1346293123
Name:ADAMS, LESSLEY BALDWIN (CRNA)
Entity Type:Individual
Prefix:
First Name:LESSLEY
Middle Name:BALDWIN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LESSLEY
Other - Middle Name:DALE
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:SUITE 404
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-9119
Mailing Address - Fax:504-779-5568
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04049367500000X
LARN081126174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1173614Medicaid
MS06376848Medicaid
LA1173614Medicaid