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NPI Code Detail

MEDICARE: LESLIE BROOK MCKENNA FNP

MEDICARE:   LESLIE BROOK MCKENNA  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner34639TN
2363L00000XNurse Practitioner4293CO

General Provider Information

NPI Number : 1912237769
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE BROOK MCKENNA FNP
Provider Business Mailing Address
First Line : 3081 BERGEN PEAK DR
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-2200
Country : US
Telephone Number : 303-674-6400
Fax Number : 303-579-3454
Provider Business Practice Location Address
First Line : 3081 BERGEN PEAK DR
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-2200
Country : US
Telephone Number : 303-674-6400
Fax Number : 303-679-3454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2009
Last Update Date : 03/05/2025

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Directions to “ LESLIE BROOK MCKENNA FNP” Practice Location

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