Provider Demographics
NPI:1619112521
Name:FRIEDMAN, LESLEY ANNE (ACNP)
Entity type:Individual
Prefix:
First Name:LESLEY ANNE
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ALLIED DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5348
Mailing Address - Country:US
Mailing Address - Phone:214-412-7465
Mailing Address - Fax:
Practice Address - Street 1:1100 ALLIED DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5348
Practice Address - Country:US
Practice Address - Phone:214-412-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX750040363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner