Healthcare Provider Details

I. General information

NPI: 1598039455
Provider Name (Legal Business Name): LESLIE P WARCUP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE P ENGLE APRN

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SW 30TH CT
MOORE OK
73160-2887
US

IV. Provider business mailing address

3300 NW 56TH ST STE. 202
OKLAHOMA CITY OK
73112-4538
US

V. Phone/Fax

Practice location:
  • Phone: 405-378-2727
  • Fax:
Mailing address:
  • Phone: 405-702-9000
  • Fax: 405-702-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number163W00000X
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number89063
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: