Provider Demographics
NPI:1528878394
Name:LESLIE, MEGAN MARGUERITE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARGUERITE
Last Name:LESLIE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1203
Mailing Address - Country:US
Mailing Address - Phone:207-417-6330
Mailing Address - Fax:
Practice Address - Street 1:12 BEECH ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1203
Practice Address - Country:US
Practice Address - Phone:207-417-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP251029363LP0808X
NH113667-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health