Healthcare Provider Details

I. General information

NPI: 1619365939
Provider Name (Legal Business Name): LESLEE A YOST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LESLEE A YOST PHRDH

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LEGGE LK
NORTH BEND NE
68649-2005
US

IV. Provider business mailing address

201 LEGGE LK
NORTH BEND NE
68649-2005
US

V. Phone/Fax

Practice location:
  • Phone: 402-672-7299
  • Fax: 402-652-8434
Mailing address:
  • Phone: 402-672-7299
  • Fax: 402-652-8434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number70
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: