Provider Demographics
NPI:1548009608
Name:KASPER, LESLIANNE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:LESLIANNE
Middle Name:
Last Name:KASPER
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 GRAND LANDINGS PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2347
Mailing Address - Country:US
Mailing Address - Phone:330-701-3291
Mailing Address - Fax:
Practice Address - Street 1:21 HOSPITAL DR STE 170A
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2454
Practice Address - Country:US
Practice Address - Phone:386-445-4734
Practice Address - Fax:386-445-8411
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARPN11031884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily