Healthcare Provider Details

I. General information

NPI: 1487766143
Provider Name (Legal Business Name): KIM M LEFLER MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3271 RACQUET CLUB DR
TRAVERSE CITY MI
49684-4770
US

IV. Provider business mailing address

9124 KIMBERLY LN
TRAVERSE CITY MI
49684-9630
US

V. Phone/Fax

Practice location:
  • Phone: 231-932-9720
  • Fax: 231-995-9302
Mailing address:
  • Phone: 231-941-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704142913
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: