Healthcare Provider Details

I. General information

NPI: 1003033382
Provider Name (Legal Business Name): LESA RENEE NOBILING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 FLETCHER AVE
LAKE CITY IA
51449-7561
US

IV. Provider business mailing address

3245 FLETCHER AVE
LAKE CITY IA
51449-7561
US

V. Phone/Fax

Practice location:
  • Phone: 712-464-7279
  • Fax:
Mailing address:
  • Phone: 712-464-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: