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General NPI Number Information
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NPI Number | 1265082978
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Entity Type | Individual
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Provider Name | LESLIE DUNCAN CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2019
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 13994 BALTIMORE AVE STE 101
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City | LAUREL
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State | MD
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Zip | 20707-5087
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Country | US
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Telephone | 240-636-9849
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Fax |
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Provider Business Mailing Address
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Address Line | 12908 GOLDEN OAK DR
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City | LAUREL
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State | MD
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Zip | 20708-2330
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Country | US
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Telephone | 301-776-4482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R199975
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License Number State | MD
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