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NPI Code Detail

MEDICARE: NICHOLAS JAMES LESKE

MEDICARE:   NICHOLAS JAMES LESKE
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
1390200000XStudent in an Organized Health Care Education/Training ProgramMI
2171M00000XCase Manager/Care CoordinatorMI

General Provider Information

NPI Number : 1881452217
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS JAMES LESKE
Provider Business Mailing Address
First Line : 316 FAIRFIELD AVE
Second Line :
City : HOLLY
State : MI
Zip : 48442-1255
Country : US
Telephone Number : 248-807-7963
Fax Number :
Provider Business Practice Location Address
First Line : 5130 ROSE HILL BLVD
Second Line :
City : HOLLY
State : MI
Zip : 48442-9507
Country : US
Telephone Number : 248-531-2403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2024
Last Update Date : 12/03/2025

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Directions to “ NICHOLAS JAMES LESKE ” Practice Location

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