Provider Demographics
NPI:1245510700
Name:KUROWSKI, LESLEY RAE
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:RAE
Last Name:KUROWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 COON RAPIDS BLVD NW
Mailing Address - Street 2:SUITE 311
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2569
Mailing Address - Country:US
Mailing Address - Phone:763-236-9090
Mailing Address - Fax:763-236-9091
Practice Address - Street 1:3960 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 311
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2569
Practice Address - Country:US
Practice Address - Phone:763-236-9090
Practice Address - Fax:763-236-9091
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 168265-0363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health