Individual
LESLIE A. BOYD-LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3014 104TH ST, LUBBOCK, TX 79423-6088
(806) 745-1656
(806) 743-2984
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
135111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85130U
BLUE CROSS & BLUE SHIELD
TX
01
—
85131U
HMO BLUE
TX
01
—
93524
PRESBYTERIAN COMMERCIAL
NM
05
—
93524
—
NM
05
—
93580584
—
NM
Enumeration date
06/27/2005
Last updated
07/09/2007
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