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General NPI Number Information
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NPI Number | 1699351742
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Entity Type | Individual
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Provider Name | NICOLE LEISHMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 4101 S. 4TH STREET TRAFFICWAY BUILDING 90 ROOM A535B
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City | LEAVENWORTH
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State | KS
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Zip | 66048
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Country | US
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Telephone | 913-682-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 S 4TH ST BLDG 90
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5014
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Country | US
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Telephone | 913-682-2000
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 13-101157-042
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 53-80058-042
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 53-80058-042
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License Number State | KS
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