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Individual

LESLIE NUSSBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3503 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1009
(502) 589-8600
(502) 589-8771
Mailing address
101 W. MUHAMMAD ALI, LOUISVILLE, KY 40202-1451
(502) 589-6000
(502) 589-8771

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
10/07/2010
Last updated
12/01/2011
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