Individual
LESLIE JO BUZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-6070
(260) 373-6704
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
28230306A
IN
363L00000X
Nurse Practitioner
Primary
71014049A
IN
Other
Enumeration date
05/22/2023
Last updated
08/30/2023
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