Individual
LESLIE M ANTONELLI
Active
Individual
LESLIE M ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28154154A
IN
363LN0000X
Neonatal Nurse Practitioner
71002959A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71002959A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200953450
—
IN
Enumeration date
01/16/2008
Last updated
05/19/2025
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