Healthcare Provider Details

I. General information

NPI: 1306986880
Provider Name (Legal Business Name): LESLIE ANN FITZHARRIS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2010
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 2010
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4415
  • Fax: 513-636-7805
Mailing address:
  • Phone: 513-636-4415
  • Fax: 513-636-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.06542
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP06542
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: