Individual
LEISA JAN BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
55 NESBIT DR, BONNE TERRE, MO 63628-1353
(573) 358-1480
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
089876
MO
Other
Enumeration date
05/13/2006
Last updated
11/26/2007
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