| Leslie Kathryn Pamungkas, MSN, RN | |
|
907 Hancock St, Prairie Grove, AR 72753-2886 | |
| (479) 713-0005 | |
| Not Available |
| Full Name | Leslie Kathryn Pamungkas |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 907 Hancock St, Prairie Grove, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952145658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WE0003X | Registered Nurse - Emergency | R069469 (Arkansas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 233191 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Leslie Kathryn Pamungkas, MSN, RN 907 Hancock St, Prairie Grove, AR 72753-2886 Ph: (479) 713-0005 | Leslie Kathryn Pamungkas, MSN, RN 907 Hancock St, Prairie Grove, AR 72753-2886 Ph: (479) 713-0005 |
Rachel Herrell, APRN FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 871 E Heritage Pkwy, Prairie Grove, AR 72753 Phone: 479-487-2001 Fax: 833-464-4150 | |
Jaynee Gail Sizemore, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 871 E Heritage Pkwy, Prairie Grove, AR 72753 Phone: 479-487-2001 Fax: 579-487-2003 | |
Kacee Bodiford, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3150 E. Heritage Pwy, Prairie Grove, AR 72753 Phone: 479-400-1140 Fax: 479-400-1151 |