# LESLIE RENE ELLIOTT

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1841365632
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA980 | KY | Yes |
| 363AM0700X | Medical Physician Assistant | PA980 | KY | — |
| 363AS0400X | Surgical Physician Assistant | PA980 | KY | — |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 08/01/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000512514 | ANTHEM BCBS | KY |
| 05 | — | 7100032550 | — | KY |
| 01 | — | DB9578 | RAILROAD MEDICARE GROUP | KY |
| 01 | — | P00454184 | RAILROAD MEDICARE PTAN | KY |