Leslie Kathryn Pamungkas, MSN, RN is a
Registered Nurse - Emergency based in Prairie Grove, Arkansas. Leslie Kathryn Pamungkas is licensed to practice in Arkansas (license number R069469) and her current practice location is
907 Hancock St, Prairie Grove, Arkansas. She can be reached at her office (for appointments etc.) via phone at
(479) 713-0005.
NPI number for Leslie Kathryn Pamungkas is 1952145658 and her current mailing address is 907 Hancock St, Prairie Grove, Arkansas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1952145658.
Provider's Profile
Full Name | Leslie Kathryn Pamungkas |
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Gender | Female |
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Speciality | Registered Nurse - Emergency |
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Location | 907 Hancock St, Prairie Grove, Arkansas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1952145658
- Provider Enumeration Date: 06/19/2024
- Last Update Date: 06/19/2024
Medical Identifiers
Medical identifiers for Leslie Kathryn Pamungkas such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952145658 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WE0003X | Registered Nurse - Emergency | R069469 (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leslie Kathryn Pamungkas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Leslie Kathryn Pamungkas, MSN, RN 907 Hancock St, Prairie Grove, AR 72753-2886 Ph: (479) 713-0005 | Leslie Kathryn Pamungkas, MSN, RN 907 Hancock St, Prairie Grove, AR 72753-2886 Ph: (479) 713-0005 |
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