Individual
LESLIE J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3431 WALKERTOWN COMMONS DR, WALKERTOWN, NC 27051-9152
(336) 564-4101
(336) 595-2035
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
12521
TN
363L00000X
Nurse Practitioner
Primary
139414
NC
363L00000X
Nurse Practitioner
5004872
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004567
—
NC
Enumeration date
04/16/2007
Last updated
12/23/2021
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