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NPI Code Detail

MEDICARE: SUZANNE LEGLEITER RN, MSN, CDE

MEDICARE:   SUZANNE  LEGLEITER  RN, MSN, CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education NutritionistRN077222AZ

General Provider Information

NPI Number : 1891940672
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE LEGLEITER RN, MSN, CDE
Provider Business Mailing Address
First Line : 11001 N BLACK CANYON HWY
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4757
Country : US
Telephone Number : 602-942-4462
Fax Number : 602-371-2002
Provider Business Practice Location Address
First Line : 2302 N 75TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85035-1216
Country : US
Telephone Number : 623-849-7500
Fax Number : 623-849-7543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2008
Last Update Date : 11/20/2008

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Directions to “ SUZANNE LEGLEITER RN, MSN, CDE” Practice Location

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