Basic Information
| Provider Information | |||||||||
| NPI: | 1750026290 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARWILE | ||||||||
| FirstName: | LESLIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 DE MOSS ST | ||||||||
| Address2: | |||||||||
| City: | LORDSBURG | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880452618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755428384 | ||||||||
| FaxNumber: | 5753138235 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N HUDSON ST | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880615516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755970211 | ||||||||
| FaxNumber: | 5755972998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2022 | ||||||||
| LastUpdateDate: | 04/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 59528 | NM | Y | Nursing Service Providers | Registered Nurse |
No ID Information.