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Individual

CHARLOTTE MARY LEITSCHUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CNP

Contact information

Practice address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 104515-8
MN
363L00000X
Nurse Practitioner
A0811011
MN
363LF0000X
Family Nurse Practitioner
Primary
2317
MN

Other

Enumeration date
10/19/2011
Last updated
07/19/2021
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