Individual
LESLIE A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5607 DICKENSON HWY, CLINTWOOD, VA 24228
(276) 926-4601
(276) 926-4602
Mailing address
5607 DICKENSON HWY, CLINTWOOD, VA 24228-7099
(276) 926-4601
(276) 926-4602
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007214
KY
363LF0000X
Family Nurse Practitioner
0024169761
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720355977
—
VA
Enumeration date
11/16/2011
Last updated
05/15/2018
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