Provider Demographics
NPI:1700937075
Name:BOYLAN, LESLIE JEAN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:JEAN
Last Name:BOYLAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:JEAN
Other - Last Name:NEAL-BOYLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:8 W. MIDDLE LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-917-6800
Mailing Address - Fax:301-917-6810
Practice Address - Street 1:8 W. MIDDLE LANE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-917-6800
Practice Address - Fax:301-917-6810
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER051556363LF0000X
CT003621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily