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General NPI Number Information
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NPI Number | 1376793349
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Entity Type | Individual
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Provider Name | LESLEY JO ALLEN APRN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 1640 FLOSSIE DR
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City | GREENDALE
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State | IN
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Zip | 47025-8424
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Country | US
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Telephone | 812-496-3285
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Fax | 812-537-0400
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Provider Business Mailing Address
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Address Line | 560 S LOOP RD
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City | EDGEWOOD
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State | KY
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Zip | 41017-3405
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Country | US
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Telephone | 859-301-2663
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Fax | 859-301-0655
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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 | COA.10389-NP
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License Number State | OH
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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 | 3005659
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71015390A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3005659
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License Number State | KY
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