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General NPI Number Information
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NPI Number | 1598005654
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Entity Type | Individual
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Provider Name | LESLIE GAYLE PHELPS ANCC
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Gender | Female
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 1013 MASTER ST
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City | CORBIN
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State | KY
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Zip | 40701-1065
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Country | US
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Telephone | 606-280-4000
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Fax | 606-280-4051
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Provider Business Mailing Address
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Address Line | PO BOX 2634
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City | CORBIN
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State | KY
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Zip | 40702-2634
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Country | US
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Telephone | 606-280-4000
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Fax | 606-280-4051
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3007920
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License Number State | KY
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