Individual
LEONARD K KOVALICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
1301 CENTRAL DR, SANFORD, NC 27330-4159
(919) 718-9512
(919) 718-9516
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
18227
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
5007064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228065
RN PERMANENT LICENCE
NC
01
—
5007064
NURSE PRACTITIONER
NC
Enumeration date
08/13/2014
Last updated
05/10/2021
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