MEDICARE: MS. LESLIE S RAIFORD NP

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	173000000X	Legal Medicine	0024165444	VA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295731883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LESLIE S RAIFORD NP

Provider Business Mailing Address
First Line	:	101C WOODMARK ST
Second Line	:
City	:	ORANGE
State	:	VA
Zip	:	22960-1246
Country	:	US
Telephone Number	:	540-672-0793
Fax Number	:	540-672-3531

Provider Business Practice Location Address
First Line	:	101C WOODMARK ST
Second Line	:
City	:	ORANGE
State	:	VA
Zip	:	22960-1246
Country	:	US
Telephone Number	:	540-672-0793
Fax Number	:	540-672-3531

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	03/06/2019

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