Provider Demographics
NPI:1932204799
Name:MATHERS-WINN, LESLIE A (FNP)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:A
Last Name:MATHERS-WINN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 VILLAGE LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2283
Mailing Address - Country:US
Mailing Address - Phone:805-688-3440
Mailing Address - Fax:805-686-5694
Practice Address - Street 1:2027 VILLAGE LN
Practice Address - Street 2:SUITE 102
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2283
Practice Address - Country:US
Practice Address - Phone:805-688-3440
Practice Address - Fax:805-686-5694
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN378394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily