Provider Demographics
NPI:1437463791
Name:WELLS, LESLIE DIONNE (RN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:DIONNE
Last Name:WELLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-7202
Mailing Address - Country:US
Mailing Address - Phone:740-405-7961
Mailing Address - Fax:
Practice Address - Street 1:431 NE 17TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2263
Practice Address - Country:US
Practice Address - Phone:740-405-7961
Practice Address - Fax:740-405-7961
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9427897163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse