Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Leslie Ann Ethridge, CRNP, FNP

Individual provider Family Nurse Practitioner · NPI 1639804560

Mrs. Leslie Ann Ethridge, CRNP, FNP is a Nurse Practitioner in Dothan, Alabama. Qualified in 2022, 4 years ago. Practices with Dale Medical Center, a 30-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
4
Licensed in
AL
In the registry since
2022
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1450 Ross Clark Cir Ste 400
Dothan, AL 36301-4770
Phone: (334) 305-0400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1-155435 (AL)

Record details

NPI number1639804560
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP , FNP
Sole proprietorNo
NPI enumeratedJuly 25, 2022
Last updated in NPPESAugust 31, 2023
Certification dateAugust 31, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Dale Medical Center — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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