Basic Information
Provider Information
NPI: 1700039070
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: LESLIE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 UNIVERSITY DR STE 300
Address2:  
City: NEWTOWN
State: PA
PostalCode: 189401873
CountryCode: US
TelephoneNumber: 2157107037
FaxNumber: 2157105181
Practice Location
Address1: 4595 NEW FALLS RD STE A
Address2:  
City: LEVITTOWN
State: PA
PostalCode: 19056
CountryCode: US
TelephoneNumber: 2675873700
FaxNumber: 2159492650
Other Information
ProviderEnumerationDate: 10/29/2008
LastUpdateDate: 05/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X26RN12647000NJN Nursing Service ProvidersRegistered Nurse 
363LF0000XF1016023PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
163W00000XRN302466LPAN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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