MEDICARE: MR. JOHN LEOGITE

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
1	363LF0000X	Family Nurse Practitioner	2033	HI
2	363LF0000X	Family Nurse Practitioner	002754	NV

General Provider Information

NPI Number	:	1740655216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN LEOGITE

Provider Business Mailing Address
First Line	:	2345 E PRATER WAY STE 100
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89434-9664
Country	:	US
Telephone Number	:	775-352-5353
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 E PRATER WAY STE 100
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89434-9664
Country	:	US
Telephone Number	:	775-352-5353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	09/11/2023

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Directions to “ MR. JOHN LEOGITE ” Practice Location

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