Individual
LESLIE GWEN GUNNERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., I.B.C.L.C.
Contact information
Practice address
678 STIERMAN WAY, EAGLE, ID 83616-5132
(208) 939-9869
Mailing address
678 STIERMAN WAY, EAGLE, ID 83616-5132
(208) 939-9869
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
N-22323
ID
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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