Provider Demographics
NPI:1366407454
Name:HOWELL, LESLIE JEANNE (DO)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:JEANNE
Last Name:HOWELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7808 RYE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-0730
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2465 E TWAIN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4011
Practice Address - Country:US
Practice Address - Phone:702-789-6260
Practice Address - Fax:702-968-4040
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11952084P0800X, 2084P0800X
OH34-00-82382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508961Medicaid
NV102324Medicare UPIN
NV100508961Medicaid