Individual
MELODY J LEISY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1313 S ST, BRIDGEPORT, NE 69336-2563
(308) 262-1616
Mailing address
1313 S ST, BRIDGEPORT, NE 69336-2563
(308) 262-1616
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112888
NE
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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