Leslie A Barstow
Nurse Practitioner, Psych/Mental Health in Ponte Vedra Beach, FL. Individual provider (NPI-1).
NPI number1578093142
StatusActive
Last updated in NPPESAug 5, 2022
Details
- NPI
- 1578093142
- Entity type
- Individual (NPI-1)
- Name
- Leslie A Barstow
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2017
- Certification date
- Aug 5, 2022
- Last updated
- Aug 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN9354746 | FL | Yes |
| 363L00000X | Nurse Practitioner | APRN9354746 | FL | |
| 363LF0000X | Nurse Practitioner, Family | APRN9354746 | FL |
Practice location
400 Colonnade Dr Ste 230Ponte Vedra Beach, FL 32081-6237
Phone 904-376-3800
Mailing address
Po Box 748519Atlanta, GA 30374-8519
Phone 904-376-3800 · Fax 904-376-3998
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