Provider Demographics
NPI:1053564773
Name:SCHELLER, LESLEY CAROLINE (RN)
Entity type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:CAROLINE
Last Name:SCHELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LESLEY
Other - Middle Name:CAROLINE
Other - Last Name:KEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1737 EASTVIEW PL
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4315
Mailing Address - Country:US
Mailing Address - Phone:805-975-3984
Mailing Address - Fax:
Practice Address - Street 1:1737 EASTVIEW PL
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-4315
Practice Address - Country:US
Practice Address - Phone:805-975-3984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA375643OtherRN LICENSE #