Individual
LESLIE NICOLE AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14700 28TH AVE N STE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
(763) 450-3986
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R238033-3
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2627
MN
Other
Enumeration date
06/03/2021
Last updated
10/29/2021
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