Individual
LESLIE ELLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5001 W BROAD ST, RICHMOND, VA 23230-3005
(877) 392-7031
Mailing address
5001 W BROAD ST, RICHMOND, VA 23230-3005
(877) 392-7031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173371
VA
Other
Enumeration date
03/04/2016
Last updated
03/17/2018
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