Individual
NAOMI LEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
510 N COURT ST, SPARTA, WI 54656-1708
(608) 633-2817
Mailing address
6743 NAUTILUS AVE, CASHTON, WI 54619-7247
(608) 487-5472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304764-31
WI
Other
Enumeration date
08/21/2012
Last updated
09/02/2012
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