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Individual

LESLIE A MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2090 S OHIO ST, SUITE 3W, SALINA, KS 67401
(785) 309-2323
(785) 309-2331
Mailing address
2090 S OHIO ST, SUITE 3W, SALINA, KS 67401
(785) 309-2323
(785) 309-2331

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-71194-071
KS
363L00000X
Nurse Practitioner
Primary
53-75191-071
KS
363LF0000X
Family Nurse Practitioner
53-75191-071
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200743910D
KS
Enumeration date
08/27/2010
Last updated
03/04/2020
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