LESLIE MARIE THEISEN (NPI# 1114400256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114400256 |
Entity Type | Individual |
Full Name | LESLIE MARIE THEISEN |
Other Name | LESLIE MARIE THEISEN |
Credential | NP-C |
Practice Address |
4880 Lawndale St Detroit MI 48210-2010 |
Practice Telephone | 3138463718 |
Practice Fax Number | 3138460150 |
Mailing Telephone | 3138466030 |
Enumeration Date | 2018-09-14 |
Last Update Date | 2019-01-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209018394 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704347248 | MI | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4880 LAWNDALE ST |
City | DETROIT |
State | MI |
Zip Code | 48210-2010 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194790071 | Josette Marie French | Family Medicine | 4880 Lawndale St, Detroit, MI 48210-2010 | 2006-02-22 |
1891330767 | Ruth Meyers | Social Worker | 4880 Lawndale St, Detroit, MI 48210-2010 | 2019-11-14 |
1699248724 | Laura Diane Sorrells | Case Manager/Care Coordinator | 4880 Lawndale St, Detroit, MI 48210-2010 | 2019-01-11 |
1942774054 | Michael Timothy Carroll | Social Worker | 4880 Lawndale St, Detroit, MI 48210-2010 | 2019-01-11 |
1598238677 | Michael Luis Meza | Counselor | 4880 Lawndale St, Detroit, MI 48210-2010 | 2019-01-10 |
1881108405 | Christopher Neil Biek | Social Worker | 4880 Lawndale St, Detroit, MI 48210-2010 | 2017-11-17 |
1033631775 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndale St, Detroit, MI 48210-2010 | 2017-07-14 |
1972955490 | Eric Leon Wilkins | Social Worker | 4880 Lawndale St, Detroit, MI 48210-2010 | 2016-07-08 |
1326404120 | Amy Runkle | Social Worker | 4880 Lawndale St, Detroit, MI 48210-2010 | 2016-01-08 |
1689039109 | Suzanne Fletcher Pappenhagen | Student in an Organized Health Care Education/Training Program | 4880 Lawndale St, Detroit, MI 48210-2010 | 2015-12-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
1942676150 | Audrey Hall | Case Manager/Care Coordinator | 6576 Woodrow St, Detroit, MI 48210 | 2015-08-12 |
1952705147 | Barbara Denise Mccowin-west | Technician, Other | 6900 Mcgraw, Detroit, MI 48210 | 2014-10-16 |
1922259456 | Dawn Marie Sanderson | Counselor | 5613 Livernois, Detroit, MI 48210 | 2008-10-02 |
1366552804 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndalestreet, Detroit, MI 48210 | 2006-08-30 |
1912950163 | Irwin Rabinowitz | Pharmacist | Junction Clinic Pharmacy 4771 Michigan Ave., Detroit, MI 48210 | 2006-05-18 |
1295229110 | Anne Marie Galus | Dentist | 5716 Michigan Ave, Detroit, MI 48210 | 2018-06-15 |
1124547948 | Sarah Fay Walsworth | Physician Assistant | 5716 Michigan Ave, Detroit, MI 48210 | 2017-09-13 |
1538305909 | Barbara Ann Menzies-williams | Internal Medicine | 6550 W Warren Ave, Detroit, MI 48210 | 2009-01-06 |
1760678437 | Clement T Piaskowski | Optometrist | 7433 Michigan Ave, Detroit, MI 48210 | 2007-09-17 |
Find all providers in zip 48210 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386243574 | Carl Andrew Ballard | Nurse Practitioner | 2635 Johnson Bottom Rd, Detroit, AL 35552-2731 | 2020-10-20 |
1639776164 | Jennifer N Fucile | Nurse Practitioner | 3800 Woodward Ave Apt 702, Detroit, MI 48201-1980 | 2020-10-07 |
1649880329 | Dedra Delane Ford | Nurse Practitioner | 18255 Birchcrest Dr, Detroit, MI 48221-2750 | 2020-08-06 |
1528695624 | Venvisor Health Michigan LLC | Nurse Practitioner | 400 Renaissance Ctr Ste 200, Detroit, MI 48243-1502 | 2020-03-26 |
1558909978 | Ruxandra Maria Lazar | Nurse Practitioner | 5285 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2019-12-16 |
1376186460 | Fazila Mahmood Siddiqui | Nurse Practitioner | 22201 Moross Rd Bldg Suite380, Detroit, MI 48236-2169 | 2019-10-22 |
1205482692 | Ladawn Denise Kennedy | Nurse Practitioner | 16645 Ilene St, Detroit, MI 48221-3401 | 2019-08-13 |
1427600246 | Christina Neirinck | Nurse Practitioner | 2401 St Antoine St, Detroit, MI 48201 | 2019-07-11 |
1548821556 | Ty R Houston | Nurse Practitioner | 13100 Corbett St, Detroit, MI 48213-2081 | 2019-06-21 |
1235795451 | Nekisha Bailey | Nurse Practitioner | 7501 Parkland, Detroit, MI 48239-1079 | 2019-05-13 |
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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.