Provider Demographics
NPI:1992391262
Name:ROMERO, LESLIE LYNN
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:LYNN
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-7019
Mailing Address - Country:US
Mailing Address - Phone:304-703-9912
Mailing Address - Fax:
Practice Address - Street 1:107 6TH ST
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-7019
Practice Address - Country:US
Practice Address - Phone:304-703-9912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant