Provider Demographics
NPI:1477898021
Name:BATTERTON, LESLIE L (APN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:L
Last Name:BATTERTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2029
Mailing Address - Country:US
Mailing Address - Phone:870-625-3228
Mailing Address - Fax:870-625-3227
Practice Address - Street 1:236 MAIN ST
Practice Address - Street 2:
Practice Address - City:MAMMOTH SPRING
Practice Address - State:AR
Practice Address - Zip Code:72554-7466
Practice Address - Country:US
Practice Address - Phone:870-625-3225
Practice Address - Fax:870-625-3227
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-09
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily