Individual
LESLIE PARDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
3919 E OVERLAND RD, MERIDIAN, ID 83642-6710
(813) 545-6883
Mailing address
304 S BLUE HERON WAY, NAMPA, ID 83687-8986
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
198356
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
77437
ID
Other
Enumeration date
04/24/2023
Last updated
04/03/2024
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