Provider Demographics
NPI:1376785964
Name:DUNLOP, LESLEY H (CNP, CNS)
Entity type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:H
Last Name:DUNLOP
Suffix:
Gender:F
Credentials:CNP, CNS
Other - Prefix:MS
Other - First Name:LESLEY
Other - Middle Name:H
Other - Last Name:MEIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP, CNS
Mailing Address - Street 1:2830 VICTORY PKWY
Mailing Address - Street 2:CENTRAL CREDENTIALING DEPARTMENT
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1785
Mailing Address - Country:US
Mailing Address - Phone:513-245-3667
Mailing Address - Fax:513-475-7259
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-558-8090
Practice Address - Fax:513-558-5791
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA01642-NS364S00000X
OHCOA11599-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMENS04501Medicare PIN