Provider Demographics
NPI:1477019834
Name:JOSEPH, LESLYN (NP)
Entity Type:Individual
Prefix:
First Name:LESLYN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-2753
Mailing Address - Country:US
Mailing Address - Phone:571-505-7576
Mailing Address - Fax:
Practice Address - Street 1:225 EAGLE CREST DR
Practice Address - Street 2:
Practice Address - City:RANGELY
Practice Address - State:CO
Practice Address - Zip Code:81648-3105
Practice Address - Country:US
Practice Address - Phone:970-675-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2238-CNP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily