Individual
GREGORY J LEIERWOOD
Active
Individual
GREGORY J LEIERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
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
Update your record
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