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Individual

GREGORY J LEIERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-2720
(612) 904-4243
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-2720
(612) 904-4243

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
351773-22
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-05389
MEDICA
MN
05
115178900
MN
01
40D80LE
BLUE CROSS BLUE SHIELD
MN
01
500025914
MEDICARE RAILROAD
MN
Enumeration date
06/11/2006
Last updated
11/28/2007
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