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Individual

JODY LEISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNS

Contact information

Practice address
500 W GRANT ST, LAKE CITY, MN 55041-1143
(651) 345-6711
Mailing address
2770 SOUTHVIEW RDG, RED WING, MN 55066-7160

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
24
MN

Other

Enumeration date
12/12/2022
Last updated
12/12/2022
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