Individual
LESLIE S. L. BROAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6 SANDPIPER PL, SUPERIOR, WI 54880-5390
(715) 817-8834
Mailing address
6 SANDPIPER PL, SUPERIOR, WI 54880-5390
(715) 817-8834
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1727748
MN
Other
Enumeration date
12/03/2010
Last updated
10/27/2014
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