Individual
JENNIFER MARIE LEITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1313 N CHEYENNE ST, BENKELMAN, NE 69021-3074
(308) 423-2204
Mailing address
1313 N CHEYENNE ST, PO BOX 626, BENKELMAN, NE 69021-3074
(308) 423-2204
(308) 423-5691
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112177
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112177
STATE LICENSE
NE
Enumeration date
02/03/2017
Last updated
02/03/2017
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