Individual
LESLIE KOOPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3920 ST FRANCIS WAY, SUITE 100, LAFAYETTE, IN 47905-4917
(765) 428-5888
(765) 428-5897
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
71001768A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201105080
—
IN
Enumeration date
07/05/2006
Last updated
02/24/2022
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