Provider Demographics
NPI:1477645430
Name:SANS, LESLEY ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:ANN
Last Name:SANS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 BEAR CLAW WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2734
Mailing Address - Country:US
Mailing Address - Phone:208-919-4898
Mailing Address - Fax:
Practice Address - Street 1:9218 BEAR CLAW WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2734
Practice Address - Country:US
Practice Address - Phone:208-919-4898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI138561367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered