Provider Demographics
NPI:1831140920
Name:NIELD ANDERSON, LESLIE JANET (ARNP; PHD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:JANET
Last Name:NIELD ANDERSON
Suffix:
Gender:F
Credentials:ARNP; PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 MCCALLISTER AVE
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-7016
Mailing Address - Country:US
Mailing Address - Phone:813-679-4434
Mailing Address - Fax:813-634-9764
Practice Address - Street 1:4020 STATE ROAD 674
Practice Address - Street 2:SUITE 11
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5285
Practice Address - Country:US
Practice Address - Phone:813-679-4434
Practice Address - Fax:813-634-9764
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9173808163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health