Provider Demographics
NPI:1871592147
Name:TESTA, LESLEE JOAN (RNC, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:LESLEE
Middle Name:JOAN
Last Name:TESTA
Suffix:
Gender:F
Credentials:RNC, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3530
Mailing Address - Country:US
Mailing Address - Phone:602-888-0448
Mailing Address - Fax:
Practice Address - Street 1:4319 W BELL RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3530
Practice Address - Country:US
Practice Address - Phone:602-888-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN087497163W00000X, 363LF0000X
AZAP1258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ187182Medicaid
AZQ44305Medicare UPIN
AZ187182Medicaid
Q44305Medicare UPIN
AZ103104Medicare PIN