Provider Demographics
NPI:1891737144
Name:SLONE, LESLIE GAY (APRN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:GAY
Last Name:SLONE
Suffix:
Gender:F
Credentials:APRN
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 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:391 W TOM T HALL BLVD
Practice Address - Street 2:
Practice Address - City:OLIVE HILL
Practice Address - State:KY
Practice Address - Zip Code:41164-7688
Practice Address - Country:US
Practice Address - Phone:606-286-8039
Practice Address - Fax:606-286-6108
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2685410Medicaid
KY78017829Medicaid
000000387531OtherANTHEM BLUE CROSS BLUE SH
KYP00430603Medicare PIN
KY0264268Medicare PIN
KY3403613Medicare PIN
000000387531OtherANTHEM BLUE CROSS BLUE SH
OH2685410Medicaid
KY0351460Medicare PIN
KY0307663Medicare PIN
KY78017829Medicaid
KY0632958Medicare PIN