Provider Demographics
NPI:1053122093
Name:WOODEN KNIFE, LESLEY RUTH (BSN-RN)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:RUTH
Last Name:WOODEN KNIFE
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 TRENTON LN
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719-9714
Mailing Address - Country:US
Mailing Address - Phone:605-545-2729
Mailing Address - Fax:
Practice Address - Street 1:265 TRENTON LN
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:SD
Practice Address - Zip Code:57719-9714
Practice Address - Country:US
Practice Address - Phone:605-545-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR059909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse