Individual
JEREMY DERRELL LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP APRN CRNA
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(651) 254-6512
(651) 254-3048
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-6512
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3041
MN
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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