Individual
LEESA K JOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8914 N PRAIRIE POINTE RD, PEORIA, IL 61615-1574
(877) 726-6494
Mailing address
204 BAYVIEW DR, EAST PEORIA, IL 61611-9669
(920) 246-5181
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.019660
IL
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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