Provider Demographics
NPI:1346678703
Name:LEGGETT, LESLIE MICHELLE (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:104 FIRESIDE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6825
Mailing Address - Country:US
Mailing Address - Phone:713-253-2120
Mailing Address - Fax:
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAVILION 2, SUITE 845
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-960-5681
Practice Address - Fax:214-947-2727
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX801481363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care