Individual
LESLIE TANEAL MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7910 E WASHINGTON ST STE 200, INDIANAPOLIS, IN 46219-5563
(317) 355-7171
(317) 355-9022
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
071008887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00416548
RAILROAD MEDICARE
IN
Enumeration date
03/28/2019
Last updated
02/13/2023
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