Provider Demographics
NPI:1770298309
Name:HEMPHILL, LESLEY (DNP, MS, FNP-C, CHES)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:DNP, MS, FNP-C, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 UINTA WAY UNIT E2
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7685
Mailing Address - Country:US
Mailing Address - Phone:435-604-0160
Mailing Address - Fax:
Practice Address - Street 1:1784 UINTA WAY # WA
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7669
Practice Address - Country:US
Practice Address - Phone:435-604-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4901790-3102163W00000X
UT4901790-4405363LF0000X
UTF06240096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse