Organization
STANVILLE AFTER HOURS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WILMA LESLIE APRN (NURSE PRACTITIONER)
(606) 478-5500
Entity
Organization
Contact information
Practice address
9405 US HIGHWAY 23 S STE 1, STANVILLE, KY 41659-9048
(606) 478-5500
(606) 478-5501
Mailing address
9405 US HIGHWAY 23 S STE 1, STANVILLE, KY 41659-9048
(606) 478-5500
(606) 478-5501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78001898
—
KY
01
—
K091560
P-TAN
KY
Enumeration date
08/14/2020
Last updated
08/31/2020
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