Leslie Burnside, PA-C

NPI 1760451454 · on the registry since 2006

Practice

Address: 147 W Chubbuck Rd
Chubbuck, ID 83202
Phone: (208) 238-7546
Fax: (208) 237-9643
Organisation at this address: Stoddard Medical, Inc
Idaho Skin Institute Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 363A00000X
363A00000X
Also registered as: 363A00000X
Licence states on file: ID, AL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2014-07-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho