Individual
CHERYL-ANN LESLIE-THEALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
953 CRAMER CT, NORTH BALDWIN, NY 11510-1216
(516) 567-3891
Mailing address
2440 E TUDOR RD, SUITE 243, ANCHORAGE, AK 99507-1185
(907) 360-9914
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0072911
NY
363A00000X
Physician Assistant
10004650
WA
363A00000X
Physician Assistant
10503
TX
363A00000X
Physician Assistant
301088
LA
363A00000X
Physician Assistant
483
AK
363A00000X
Physician Assistant
52939
CA
363A00000X
Physician Assistant
8612468-1206
UT
363A00000X
Physician Assistant
PA 9103798
FL
Other
Enumeration date
10/16/2006
Last updated
05/24/2019
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