1801051610 NPI number — MS. LESLIE BYRNE N.P.

Table of content: MS. LESLIE BYRNE N.P. (NPI 1801051610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801051610 NPI number — MS. LESLIE BYRNE N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BYRNE
Provider First Name:
LESLIE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUBON
Provider Other First Name:
LESLIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801051610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7618 TRAPPERS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28311-7421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-339-8617
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 MEDICAL CENTER ROAD
Provider Second Line Business Practice Location Address:
PO DRAWER B - HWY 421
Provider Business Practice Location Address City Name:
MAMERS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-893-5402
Provider Business Practice Location Address Fax Number:
910-893-2567
Provider Enumeration Date:
07/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5004045 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)