| Doctor Name: | LESLEY A FUERST |
| NPI Number: | 1548516941 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | F0712543 |
| Business Practice Address: | 370 S Main St Clintonville, WI - 549291632 |
| Business Phone Number: | 7158235161 |
| Business Fax Number: | 7158231386 |
| Mailing Address: | Po Box 8003, APPLETON |
| State: | WI |
| Postal Code: | 549128003 |
| Phone Number: | 9209963200 |
| Fax Number: | 9207385787 |
| NPI Enumeration Date: | 08/03/2012 |
| NPI Last Update Date: | 03/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F0712543 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |