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General NPI Number Information
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NPI Number | 1316424666
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Entity Type | Individual
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Provider Name | LESLIE MARIE FILLER DNP, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 420 POLIFKA DR BLDG 1042
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City | SHAW AFB
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State | SC
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Zip | 29152-5100
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Country | US
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Telephone | 803-895-6425
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Fax |
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Provider Business Mailing Address
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Address Line | 420 POLIFKA DR BLDG 1042
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City | SHAW AFB
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State | SC
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Zip | 29152-5100
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Country | US
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Telephone |
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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 | 201805806NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN4283
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 58600
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License Number State | ID
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