Provider Demographics
NPI:1063711133
Name:STERN, LESLIE (CNM, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:STERN
Suffix:
Gender:
Credentials:CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 VIRGIE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-9065
Mailing Address - Country:US
Mailing Address - Phone:919-401-2420
Mailing Address - Fax:
Practice Address - Street 1:1911 HILLANDALE RD STE 1010
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2666
Practice Address - Country:US
Practice Address - Phone:919-401-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11066946163WL0100X
NC194134163W00000X
NYF000810-1367A00000X
NC553367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse