Individual
LESLIE A HASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
475 POLK ST STE F, TWIN FALLS, ID 83301-4864
(208) 751-9708
(208) 736-0890
Mailing address
3704 N 2200 E, FILER, ID 83328-5260
(208) 751-9708
(208) 736-0890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-1571A
ID
363LG0600X
Gerontology Nurse Practitioner
NP-1571A
ID
Other
Enumeration date
06/08/2015
Last updated
05/09/2023
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