Provider Demographics
NPI:1457818841
Name:LEGLER, CODY (DNP, NP-BC)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:LEGLER
Suffix:
Gender:M
Credentials:DNP, NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PIERCE ST NE UNIT 1035
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2099
Mailing Address - Country:US
Mailing Address - Phone:920-889-9828
Mailing Address - Fax:
Practice Address - Street 1:9309 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1620
Practice Address - Country:US
Practice Address - Phone:301-493-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224624363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health