Leslie Kathryn Pamungkas, DNP, APRN, FNP-BC
Nurse Practitioner, Family in Van Buren, AR. Individual provider (NPI-1).
NPI number1952145658
StatusActive
Last updated in NPPESOct 26, 2025
Details
- NPI
- 1952145658
- Entity type
- Individual (NPI-1)
- Name
- Leslie Kathryn Pamungkas
- Credential
- DNP, APRN, FNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 19, 2024
- Certification date
- Oct 26, 2025
- Last updated
- Oct 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 233191 | AR | Yes |
| 163WE0003X | Registered Nurse, Emergency | R069469 | AR |
Practice location
606 Co Op DrVan Buren, AR 72956-6083
Phone 479-474-4249
Mailing address
606 Co Op DrVan Buren, AR 72956-6083
Phone 479-474-4249
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