Provider Demographics
NPI:1215290242
Name:CHAPMAN, LESLIE M (LPN)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:M
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:M
Other - Last Name:QUILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:116 BUSH ST
Mailing Address - Street 2:APT 1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2415
Mailing Address - Country:US
Mailing Address - Phone:954-681-9160
Mailing Address - Fax:
Practice Address - Street 1:116 BUSH ST
Practice Address - Street 2:APT 1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-2415
Practice Address - Country:US
Practice Address - Phone:954-681-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278763-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse