Individual
LESLIE MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5745 HIGHWAY 17, WINNSBORO, LA 71295-5688
(318) 722-3333
Mailing address
PO BOX 1300, WINNSBORO, LA 71295-1300
(318) 412-5265
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP.213639
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14679527
CAQH
—
01
—
1D4182
MEDICARE
LA
05
—
2528041
—
LA
01
—
P02480309
RRMEDICARE
LA
Enumeration date
06/01/2020
Last updated
04/07/2021
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