MEDICARE: LESLI A HARDING RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0040767	OH

General Provider Information

NPI Number	:	1558157701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLI A HARDING RN

Provider Business Mailing Address
First Line	:	2820 W MARKET ST STE 110
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-4024
Country	:	US
Telephone Number	:	330-835-4000
Fax Number	:	330-835-4040

Provider Business Practice Location Address
First Line	:	2820 W MARKET ST STE 110
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-4024
Country	:	US
Telephone Number	:	330-835-4000
Fax Number	:	330-835-4040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	04/08/2026

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