Individual
LESLIE HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9204
(262) 329-3127
(262) 329-3520
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9065-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100086809
—
WI
Enumeration date
02/20/2019
Last updated
04/01/2025
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