Individual
LORI L LEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027-2684
(262) 670-4000
(262) 670-4001
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7646-33
WI
Other
Enumeration date
04/18/2017
Last updated
10/25/2023
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