Provider Demographics
NPI:1972810968
Name:HALL, LESLEY S (RN)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:S
Last Name:HALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 LITTLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-1523
Mailing Address - Country:US
Mailing Address - Phone:513-889-4073
Mailing Address - Fax:
Practice Address - Street 1:169 LITTLEBROOK DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-1523
Practice Address - Country:US
Practice Address - Phone:513-889-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.359861163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse