Provider Demographics
NPI:1558097642
Name:SPENCER, LESLIE EPPERLY (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:EPPERLY
Last Name:SPENCER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3330
Mailing Address - Country:US
Mailing Address - Phone:307-682-8110
Mailing Address - Fax:
Practice Address - Street 1:1304 W 4TH ST
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3330
Practice Address - Country:US
Practice Address - Phone:307-685-1193
Practice Address - Fax:307-685-1193
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY52021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily