Provider Demographics
NPI:1851971956
Name:SHELTON, LESLIE ANN (DO)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 N 44TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6461
Mailing Address - Country:US
Mailing Address - Phone:480-882-7360
Mailing Address - Fax:480-882-5866
Practice Address - Street 1:3311 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6461
Practice Address - Country:US
Practice Address - Phone:480-882-7360
Practice Address - Fax:480-882-5866
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program