| NPI | 1275290066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY PAULINE LESCHINSKY Np 615-901-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2024-07-24 |