Individual
MRS. LESLIE ANN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2340 W SYCAMORE ST, KOKOMO, IN 46901-4108
(765) 210-0533
Mailing address
2340 W SYCAMORE ST, KOKOMO, IN 46901-4108
(765) 210-0533
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000434A
IN
363LF0000X
Family Nurse Practitioner
7100343A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200263710A
—
IN
01
—
28080669A
RN LICENSE
IN
01
—
71000434A
NP AUTHORIZATION
IN
01
—
71000434B
CSR REFERENCE CARD
IN
Enumeration date
11/09/2005
Last updated
12/28/2015
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