| Doctor Name: | LESLIANNE GRENDYSZ |
| NPI Number: | 1346470598 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LNP |
| License Number: | 0024168382 |
| Business Practice Address: | 12825 Minnieville Rd Suite 202 Lake Ridge, VA - 221923618 |
| Business Phone Number: | 7037802800 |
| Business Fax Number: | 7037800461 |
| Mailing Address: | 12825 Minnieville Rd, Suite 202 LAKE RIDGE |
| State: | VA |
| Postal Code: | 221923618 |
| Phone Number: | 7037802800 |
| Fax Number: | 7037800461 |
| NPI Enumeration Date: | 07/22/2009 |
| NPI Last Update Date: | 10/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024168382 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |