Provider Demographics
NPI:1770451049
Name:LESLIE, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:LESLIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 WINTERBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:TN
Mailing Address - Zip Code:38052-8211
Mailing Address - Country:US
Mailing Address - Phone:731-518-7558
Mailing Address - Fax:
Practice Address - Street 1:178 WINTERBERRY CIR
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:TN
Practice Address - Zip Code:38052-8211
Practice Address - Country:US
Practice Address - Phone:731-518-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer