Provider Demographics
NPI:1902588098
Name:LESLIE, MATLEENA ELISABETH (MSN, APRN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MATLEENA
Middle Name:ELISABETH
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MSN, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 HEATHER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5820
Mailing Address - Country:US
Mailing Address - Phone:214-534-4756
Mailing Address - Fax:
Practice Address - Street 1:136 HEATHER GLEN DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5820
Practice Address - Country:US
Practice Address - Phone:214-534-4756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130525363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health