Provider Demographics
NPI:1124665161
Name:ROSAS, LESLEE RICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:LESLEE
Middle Name:RICHELLE
Last Name:ROSAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:LESLEE
Other - Middle Name:RICHELLE
Other - Last Name:AVALOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2701 S GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1979
Mailing Address - Country:US
Mailing Address - Phone:806-350-8980
Mailing Address - Fax:806-350-7573
Practice Address - Street 1:2701 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1979
Practice Address - Country:US
Practice Address - Phone:806-350-8980
Practice Address - Fax:806-350-7573
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily