Provider Demographics
NPI:1386146694
Name:HOFER, LESLEY (APRN)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:HOFER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:LESLEY
Other - Middle Name:A
Other - Last Name:HOFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LESLEY CLARK RN
Mailing Address - Street 1:9301 W 74TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2217
Mailing Address - Country:US
Mailing Address - Phone:913-632-9100
Mailing Address - Fax:913-632-9159
Practice Address - Street 1:9301 W 74TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2217
Practice Address - Country:US
Practice Address - Phone:913-632-9100
Practice Address - Fax:913-632-9159
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78093363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS78093OtherKANSAS STATE BOARD OF NURSING