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Individual

CONNIE S LEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
322 N MAIN ST, KOKOMO, IN 46290-4622
(765) 453-8555
(765) 453-8020
Mailing address
6626 E 75TH STREET, STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
70000185A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000846427
ANTHEM BCBS
IN
01
600001199
MAGELLAN
IN
Enumeration date
08/10/2006
Last updated
03/21/2014
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