Individual
LESLIE E. VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
661458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196885101
—
TX
01
—
8Y9074
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/03/2008
Last updated
10/28/2024
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