Provider Demographics
NPI:1699036541
Name:CARTER, LESLI ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:LESLI
Middle Name:ANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950293
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0293
Mailing Address - Country:US
Mailing Address - Phone:888-987-1785
Mailing Address - Fax:405-609-1491
Practice Address - Street 1:5120 DIXIE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1702
Practice Address - Country:US
Practice Address - Phone:502-448-7853
Practice Address - Fax:502-448-2281
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007470363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics