Provider Demographics
NPI:1447310172
Name:SHARPE, LESLIE MCDONOUGH (NP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MCDONOUGH
Last Name:SHARPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MALDON DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-1752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7718 SYLVAN RD
Practice Address - Street 2:
Practice Address - City:SNOW CAMP
Practice Address - State:NC
Practice Address - Zip Code:27349-9504
Practice Address - Country:US
Practice Address - Phone:336-506-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP83160Medicare UPIN