Healthcare Provider Details

I. General information

NPI: 1962423533
Provider Name (Legal Business Name): LESLIE A. MC COWAN RN, GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE A PATTERSON RN, GNP

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 W 2ND PL MEDICAL PLAZA II, SUITE 4-450
LAKEWOOD CO
80228-1573
US

IV. Provider business mailing address

11700 W 2ND PL MEDICAL PLAZA II, SUITE 4-450
LAKEWOOD CO
80228-1573
US

V. Phone/Fax

Practice location:
  • Phone: 303-825-1234
  • Fax: 720-321-8121
Mailing address:
  • Phone: 303-825-1234
  • Fax: 720-321-8121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71309
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: