Healthcare Provider Details

I. General information

NPI: 1447202312
Provider Name (Legal Business Name): LINDA L LESLIE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA L HOFF ARNP

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 13TH AVE N
CLINTON IA
52732-5067
US

IV. Provider business mailing address

915 13TH AVE N
CLINTON IA
52732-5067
US

V. Phone/Fax

Practice location:
  • Phone: 563-243-2511
  • Fax: 563-243-0817
Mailing address:
  • Phone: 563-243-2511
  • Fax: 563-243-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF088100
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: