Provider Demographics
NPI:1730449661
Name:HARPER, LESLIE RENEE (RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:RENEE
Last Name:HARPER
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 CROSS POINT CIR APT 14
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-8436
Mailing Address - Country:US
Mailing Address - Phone:704-491-3876
Mailing Address - Fax:
Practice Address - Street 1:2604 CROSS POINT CIR APT 14
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-8436
Practice Address - Country:US
Practice Address - Phone:704-491-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005961133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered