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Individual

LESLIE PRESTENBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
843 MILLING AVE, LULING, LA 70070-4442
(985) 307-1600
(504) 575-3691
Mailing address
2900 INDIANA AVE, KENNER, LA 70065-4605
(504) 575-3712
(504) 575-3691

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APO7977
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03684747
MS
05
2377116
LA
Enumeration date
08/12/2014
Last updated
03/21/2017
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