Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP6387 | AZ |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN080717 | AZ |
NPI | 1265689970 |
---|---|
Provider Name | Ms. Debra Malecki Ledington |
First Address | Flagstaff, AZ 86001-3118 |
Second Address | Flagstaff, AZ 86001-3118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2008 |
Last Update Date | 01/05/2017 |