Individual
MRS. LESLEY SUSANNE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
913 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 819-7103
(208) 719-0050
Mailing address
913 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 217-2529
(208) 262-7461
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1508
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568695062
—
ID
Enumeration date
08/31/2009
Last updated
06/20/2023
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