Individual
MISTY RAE LEDESMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
32652 KNO, DOWAGIAC, MI 49047-9805
(269) 782-4141
(269) 783-1236
Mailing address
60207 65TH ST, HARTFORD, MI 49057-8711
(269) 674-9909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704244777
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4204244777
MI
Other
Enumeration date
03/31/2020
Last updated
11/09/2023
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