Provider Demographics
NPI:1245703065
Name:PARKER, LESLIE COBB (NP)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:COBB
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:167 HODGES RD
Mailing Address - Street 2:
Mailing Address - City:DEEP GAP
Mailing Address - State:NC
Mailing Address - Zip Code:28618-8214
Mailing Address - Country:US
Mailing Address - Phone:910-622-1163
Mailing Address - Fax:
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011332363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner