Provider Demographics
NPI:1669271151
Name:COLE, LESLIE MORGAN (PA)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MORGAN
Last Name:COLE
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 SHEFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1549
Mailing Address - Country:US
Mailing Address - Phone:703-868-0536
Mailing Address - Fax:
Practice Address - Street 1:206 SHEFFIELD RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1549
Practice Address - Country:US
Practice Address - Phone:703-868-0536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program