Individual
LESLIE M TOLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 E 10TH ST, ANNISTON, AL 36207-4716
(256) 235-5190
Mailing address
PO BOX 10484, BIRMINGHAM, AL 35202-0484
(205) 322-1808
(205) 322-1851
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-058782
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51526003
BLUE SHIELD
AL
Enumeration date
05/11/2006
Last updated
07/08/2007
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