Individual
LESLIE ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 PROFESSIONAL WAY, KENDALLVILLE, IN 46755-2927
(260) 347-8556
(260) 347-8557
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009252A
IN
Other
Enumeration date
06/24/2019
Last updated
10/12/2022
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