Individual
STEPHANIE L LEDL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2055 S FREMONT AVE, SUITE 1000, SPRINGFIELD, MO 65804-2206
(417) 820-8099
(417) 820-8093
Mailing address
2055 S FREMONT AVE, SUITE 1000, SPRINGFIELD, MO 65804-2206
(417) 820-8099
(417) 820-8093
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2002018100
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730329640
—
MO
05
—
176560758
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00700785
RAILROAD MEDICARE
—
Enumeration date
03/05/2009
Last updated
06/12/2009
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