Individual
MAI YANG LEICHTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 CLEVELAND AVE N, ROSEVILLE, MN 55113-2701
(651) 757-0187
Mailing address
336 PARKVIEW CT S, MAPLEWOOD, MN 55119-6916
(651) 757-0187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2040767
MN
363L00000X
Nurse Practitioner
Primary
9091
MN
Other
Enumeration date
02/06/2022
Last updated
10/10/2023
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