Provider Demographics
NPI:1588756605
Name:LESLIE, INGELIN LONO (NP)
Entity type:Individual
Prefix:MRS
First Name:INGELIN
Middle Name:LONO
Last Name:LESLIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:INGELIN
Other - Middle Name:
Other - Last Name:LONO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2921 HICKORY COURT
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3114
Mailing Address - Country:US
Mailing Address - Phone:785-537-8708
Mailing Address - Fax:785-537-3186
Practice Address - Street 1:BUILDING 7665 NORMANDY ROAD
Practice Address - Street 2:CALDWELL CLINIC
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-239-9859
Practice Address - Fax:785-240-2110
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1451004011163W00000X
KS44330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily