Individual
LESLIE MARIE MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3050 RIO DOSA DR, LEXINGTON, KY 40509-1540
(859) 268-6410
(859) 268-6473
Mailing address
3050 RIO DOSA DR, LEXINGTON, KY 40509-1540
(859) 268-6410
(859) 268-6473
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3008043
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
05/09/2013
Last updated
01/22/2015
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