MEDICARE: MRS. LESLIE DENISE PINSON APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SW0102X	Women's Health Clinical Nurse Specialist	3006407	KY
2	363LW0102X	Women's Health Nurse Practitioner	3006407	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255655155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LESLIE DENISE PINSON APRN

Provider Business Mailing Address
First Line	:	1221 S BROADWAY
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2701
Country	:	US
Telephone Number	:	859-258-6200
Fax Number	:	859-258-6203

Provider Business Practice Location Address
First Line	:	160 N EAGLE CREEK DR STE 400
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2124
Country	:	US
Telephone Number	:	859-258-5220
Fax Number	:	859-258-5405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	01/27/2025

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