Provider Demographics
NPI:1508268095
Name:MUENZLER, LESLIE CERNOSEK (NP-C)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:CERNOSEK
Last Name:MUENZLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 JEWELL DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6630
Mailing Address - Country:US
Mailing Address - Phone:254-753-3646
Mailing Address - Fax:254-753-1411
Practice Address - Street 1:221 JEWELL DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6630
Practice Address - Country:US
Practice Address - Phone:254-753-3646
Practice Address - Fax:254-753-1411
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily