Individual
STEPHANIE LEONARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2985 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 523-3373
(208) 523-8746
Mailing address
2985 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 523-3373
(208) 523-8746
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP1498A
ID
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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