Individual
JUDY ANN LEISETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3208 N ACADEMY BLVD, SUITE 150, COLORADO SPRINGS, CO 80917-5161
(719) 573-1388
Mailing address
1148 COLLINS RD, COLORADO SPRINGS, CO 80920-3256
(719) 264-1538
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
54964
CO
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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