Provider Demographics
NPI:1194269464
Name:BRANSFORD, LESLYE C (NP-C)
Entity type:Individual
Prefix:
First Name:LESLYE
Middle Name:C
Last Name:BRANSFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-4764
Mailing Address - Country:US
Mailing Address - Phone:270-559-5958
Mailing Address - Fax:
Practice Address - Street 1:1313 JOHNSON BLVD
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2925
Practice Address - Country:US
Practice Address - Phone:270-917-1401
Practice Address - Fax:270-957-8811
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010922363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily