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General NPI Number Information
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NPI Number | 1376975797
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Entity Type | Individual
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Provider Name | LESLIE POWELL PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1855 W MAIN ST
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City | NEWARK
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State | OH
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Zip | 43055-1135
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Country | US
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Telephone | 614-257-4628
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Fax |
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Provider Business Mailing Address
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Address Line | 1855 W MAIN ST
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City | NEWARK
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State | OH
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Zip | 43055-1135
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Country | US
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Telephone | 804-269-1576
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3017888
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024192191
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 101.0137517TELE
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP14973
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License Number State | OH
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