Individual
LESLIE DALE LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC FNP WHNP
Contact information
Practice address
106 W. EDWARDS, MARYVILLE, MO 64468
(660) 562-2273
(660) 562-3530
Mailing address
106 W. EDWARDS, MARYVILLE, MO 64468
(660) 562-2273
(660) 562-3530
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
122210
MO
363LW0102X
Women's Health Nurse Practitioner
122210
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424794410
—
MO
Enumeration date
01/26/2006
Last updated
03/02/2009
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