Provider Demographics
NPI:1447806393
Name:DAVIS-PAIGE, LESLIE DENISE (RN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:DENISE
Last Name:DAVIS-PAIGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:D
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:37327 N GANTZEL RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7388
Mailing Address - Country:US
Mailing Address - Phone:480-498-0501
Mailing Address - Fax:
Practice Address - Street 1:37327 N GANTZEL RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7388
Practice Address - Country:US
Practice Address - Phone:480-498-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ188558163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool