Provider Demographics
NPI:1912286485
Name:KUMPF, LESILE (RRT, AE-C, CPFT)
Entity Type:Individual
Prefix:
First Name:LESILE
Middle Name:
Last Name:KUMPF
Suffix:
Gender:F
Credentials:RRT, AE-C, CPFT
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:TRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT, AE-C
Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2745
Mailing Address - Country:US
Mailing Address - Phone:505-272-2218
Mailing Address - Fax:505-272-0073
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2745
Practice Address - Country:US
Practice Address - Phone:505-272-2218
Practice Address - Fax:505-272-0073
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2906227900000X, 2279E1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No2279E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEducational