Healthcare Provider Details

I. General information

NPI: 1881277150
Provider Name (Legal Business Name): LESLY APAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ARTHUR DR
THOMASVILLE NC
27360-6275
US

IV. Provider business mailing address

19 BIRCHWOOD CT
THOMASVILLE NC
27360-7959
US

V. Phone/Fax

Practice location:
  • Phone: 336-475-2348
  • Fax:
Mailing address:
  • Phone: 336-561-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5014385
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: