Individual
LESLIE PRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3003 UNIVERSITY DR, MARINETTE, WI 54143-4110
(715) 735-4200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4345
WI
363A00000X
Physician Assistant
5601008144
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078218
—
WI
Enumeration date
03/02/2017
Last updated
03/18/2025
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