Wizauer, Leslie A.

Wizauer, Leslie A. is an individual health care provider with primary practice located at 12198 Mantawauka Dr , Fenton MI 48430-8853. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Wizauer, Leslie A. can be contacted via phone (810) 996-4775.

Contact Information

Primary practice address
12198 Mantawauka Dr Fenton MI 48430-8853
Phone: (810) 996-4775
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 106426 Michigan

Profile Details

NPI number 1205847316
LBN Legal business name Wizauer, Leslie A.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Apr 8th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205847316 NPPES
Michigan MEDICAID 101850691
Michigan Other 0B56166

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