Provider Demographics
NPI:1992772602
Name:MCCUTCHEON, LESLIE ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 SE CARY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7413
Practice Address - Country:US
Practice Address - Phone:919-467-4992
Practice Address - Fax:919-481-9607
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085001375363A00000X
NC0010-02396363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant