# LESLY TATIANA ORTIZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154623015
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 15-02211 | KS | Yes |
| 363AM0700X | Medical Physician Assistant | 15-02211 | KS | — |

## Other

- **Enumeration date:** 11/29/2010
- **Last updated:** 03/04/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201243810A | — | KS |