Provider Demographics
NPI:1366902223
Name:DUFF, LESLIE ROBIN (APRN)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ROBIN
Last Name:DUFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 LEE COUNTY ADJUSTMENT CENTER
Mailing Address - Street 2:
Mailing Address - City:BEATTYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41311-9724
Mailing Address - Country:US
Mailing Address - Phone:606-464-2866
Mailing Address - Fax:
Practice Address - Street 1:168 LEE COUNTY ADJUSTMENT CENTER
Practice Address - Street 2:
Practice Address - City:BEATTYVILLE
Practice Address - State:KY
Practice Address - Zip Code:41311-9724
Practice Address - Country:US
Practice Address - Phone:606-464-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013245363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
2021014726OtherAMERICAN NURSES CREDENTIALING CENTER
F02191120OtherCERTIFICATION NUMBER
KY3013245OtherSTATE LICENSE NUMBER