Individual
LESLEY JORGENSEN KLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4430 E RAY RD, PHOENIX, AZ 85044-6092
(866) 389-2727
Mailing address
374 W CITATION LN, TEMPE, AZ 85284-1358
(480) 707-3284
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8476
AZ
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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