Provider Demographics
NPI:1912033689
Name:BREWINGTON, LESLIE CAMILLE O'NEAL (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:CAMILLE O'NEAL
Last Name:BREWINGTON
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:65 LAKEWOOD VW
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-6276
Mailing Address - Country:US
Mailing Address - Phone:336-442-5012
Mailing Address - Fax:336-282-1252
Practice Address - Street 1:5587 GARDEN VILLAGE WAY STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410
Practice Address - Country:US
Practice Address - Phone:336-282-1251
Practice Address - Fax:336-282-1252
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201644363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily