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General NPI Number Information
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NPI Number | 1073145413
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Entity Type | Individual
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Provider Name | MADELINE ROSE LEITER MS, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 4435 O ST STE 211
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City | LINCOLN
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State | NE
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Zip | 68510-1864
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Country | US
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Telephone | 402-489-2218
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Fax |
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Provider Business Mailing Address
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Address Line | 815 S 38TH STREET CT APT 2
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City | LINCOLN
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State | NE
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Zip | 68510-3576
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Country | US
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Telephone | 402-770-0750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16560
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14327
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License Number State | NE
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