Individual
LESLYE GWEN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
362 W 15TH ST, INDIANAPOLIS, IN 46202-2266
(317) 948-5450
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
28195315A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008072A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262210037
MEDICARE PTAN
IN
05
—
300016348
—
IN
Enumeration date
01/18/2018
Last updated
02/13/2025
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