LESLIE HAGENSTEIN (NPI# 1093799132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093799132 |
| Entity Type | Individual |
| Full Name | LESLIE HAGENSTEIN |
| Credential | DNP, APRN, FNP-BC |
| Practice Address |
103 W 3rd Street New Physical Address Marbleton WY 83113 |
| Mailing Address |
Po Box E 9615 Hwy 191 Pinedale WY 82941-3040 |
| Practice Telephone | 3072763306 |
| Practice Fax Number | 3072763024 |
| Mailing Telephone | 3072319562 |
| Mailing Fax Number | 3072763024 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2017-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
340 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8665.0048 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 124348900 | 05 |
| Street Address |
103 W 3RD STREET NEW PHYSICAL ADDRESS |
| City | MARBLETON |
| State | WY |
| Zip Code | 83113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932380839 | Selanie A. Sanone - Leavitt | Nurse Practitioner | 103 W 3rd Street, Marbleton, WY 83113 | 2007-11-19 |
| 1609827435 | Sublette County Rural Health Care District | Family Medicine | 103 W 3rd Street, Marbleton, WY 83113 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255724258 | Jason L Ray | Physician Assistant | 103 W. 3rd St., Marbleton, WY 83113 | 2015-03-15 |
| 1043629819 | Krista Louise Manning | Speech-Language Pathologist | 450 Sunshine Dr., Big Piney, WY 83113 | 2014-08-06 |
| 1912102989 | Brendan H Fitzsimmons | Family Medicine | 103 W 3rd St., Marbleton, WY 83113 | 2007-06-19 |
| 1750414538 | Scott William Houfek | Dentist | 16 West 3rd Street, Big Piney, WY 83113 | 2007-03-13 |
| 1003958018 | Robert H Bailey | Pharmacy | 501 Nichols St, Big Piney, WY 83113 | 2007-02-13 |
| 1265583082 | Carol Ann Deno | Pharmacist | 501 North Nichols St., Big Piney, WY 83113 | 2007-01-16 |
| 1760579023 | William David Mills Burnett | Family Medicine | 16 West 3rd St., Marbleton, WY 83113 | 2006-10-06 |
| 1518054782 | Lorri N Turner | Nurse Practitioner | 307 Main, Marbleton, WY 83113-0000 | 2006-10-06 |
| 1578649562 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 545 Budd Ave, Big Piney, WY 83113-0767 | 2006-10-31 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518054782 | Lorri N Turner | Nurse Practitioner | 307 Main, Marbleton, WY 83113-0000 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012383 | Susan M. Miner | Nurse Practitioner | 487 N. Main St. #2, Thayne, WY 83127 | 2020-10-27 |
| 1922606177 | Crysta Jean Sullivan | Nurse Practitioner | 2401 Greenway Dr, Gillette, WY 82716-2333 | 2020-10-10 |
| 1245844463 | Lara Vanden Hoek | Nurse Practitioner | 3339 Hales Ranch Rd, Cheyenne, WY 82007-1825 | 2020-09-04 |
| 1417560020 | Camlyn Dunn | Nurse Practitioner | 17985 Us Highway 14, Moorcroft, WY 82721-8814 | 2020-08-25 |
| 1649897406 | Anne Barnes | Nurse Practitioner | 4003 Rawlins St Ste A, Cheyenne, WY 82001-1800 | 2020-06-28 |
| 1548882343 | Evolving Ehealth LLC | Nurse Practitioner | 1309 Coffeen Ave Ste 1200, Sheridan, WY 82801-5777 | 2020-05-14 |
| 1316578826 | Karen Ann Alexander | Nurse Practitioner | 921 S Ballancee Ave, Lusk, WY 82225 | 2020-02-03 |
| 1801436274 | Susan Ranea Roberson | Nurse Practitioner | 69 Valley Dr, Casper, WY 82604-4011 | 2020-01-13 |
| 1497390017 | William Carey Lake | Nurse Practitioner | 1025 Jade Drivee, Hanna, WY 82327-8232 | 2019-11-07 |
| 1184266058 | Kelsie Anderson | Nurse Practitioner | 1423 W 31st St, Cheyenne, WY 82001-2458 | 2019-10-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.