MS. KELLY LAUREN LEIST


Address: 1902 Mead Ave, Sheboygan, WI 53081-6140
Phone: 4143294979

MS. KELLY LAUREN LEIST (NPI# 1922636877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922636877
Entity Type Individual
Full Name MS. KELLY LAUREN LEIST
Credential NP-C
Practice Address 1902 Mead Ave
Sheboygan
WI 53081-6140
Mailing Address 3301 W Forest Home Ave
Milwaukee
WI 53215-2843
Practice Telephone 4143294979
Mailing Telephone 4143892233
Enumeration Date 2020-03-27
Last Update Date 2020-05-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 9892 WI Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
F12190231 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 100099262 05

Office Location

Street Address 1902 MEAD AVE
City SHEBOYGAN
State WI
Zip Code 53081-6140

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639245558 Extendicare Homes, Inc. Skilled Nursing Facility 1902 Mead Ave, Sheboygan, WI 53081-6140 2006-11-24
1962064436 Courtney F Klatt Nurse Practitioner 1902 Mead Ave, Sheboygan, WI 53081-6140 2019-07-03
1073172920 Emilee Daehnert Occupational Therapy Assistant 1902 Mead Ave, Sheboygan, WI 53081-6140 2019-06-12
1750809547 Nsh Progressive LLC Skilled Nursing Facility 1902 Mead Ave, Sheboygan, WI 53081-6140 2017-09-01
1841733060 Hailey Amber Skiba Speech-Language Pathologist 1902 Mead Ave, Sheboygan, WI 53081-6140 2016-11-19
1568911956 Constance Salm Physical Therapy Assistant 1902 Mead Ave, Sheboygan, WI 53081-6140 2016-09-26
1790140184 Caroline Matlock Occupational Therapy Assistant 1902 Mead Ave, Sheboygan, WI 53081-6140 2015-12-29
1700254000 Jamie Swifka Physical Therapy Assistant 1902 Mead Ave, Sheboygan, WI 53081-6140 2015-09-03
1881083228 Fmg Mead Avenue Wisconsin LLC Skilled Nursing Facility 1902 Mead Ave, Sheboygan, WI 53081-6140 2015-01-22
1316341803 Emily Liesener Physical Therapist 1902 Mead Ave, Sheboygan, WI 53081-6140 2014-10-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770053696 Kathy Hughes Counseling, LLC Community/Behavioral Health 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 2018-12-04
1780159004 Great Lakes Clinic and Consultants, LLC Clinic/Center 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 2018-10-13
1174032106 Laura Elizabeth Manning Registered Nurse 325 Linocln Ave, Sheboygan, WI 53081 2017-09-21
1043733686 Chasidy D Wilke Behavioral Analyst 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 2017-07-25
1700320074 Darlene Wilken Counselor 2842 S. Business Dr, Sheboygan, WI 53081 2016-12-06
1942652185 Jacob Steven Son Dentist 3555 Wasington Ave., Sheboygan, WI 53081 2016-07-12
1225491749 Cassandra Lea Loehndorf Social Worker 3321 S. 12th St., Sheboygan, WI 53081 2016-04-01
1003201112 Jason Meinhardt Dentist 2115 S Memorial Pl, Sheboygan, WI 53081 2015-04-06
1346634110 Christopher Lenz Specialist/Technologist 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 2015-03-19
1780008060 James Simac Counselor 503 Wisconsin Ave., Sheboygan, WI 53081 2014-02-07
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104044395 Connie Lee Worm Nurse Practitioner 2108 Kohler Memorial Dr, Sheboygan, WI 53081-3100 2007-04-23
1235252339 Annette Vonfrankenberg Nurse Practitioner 924 N Taylor Dr, Sheboygan, WI 53081-4202 2007-04-06
1316073836 Karen S Lim Nurse Practitioner 1721 Saemann Ave, Sheboygan, WI 53081 2007-02-26
1154961050 Stephanie L Holschbach Nurse Practitioner 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 2020-01-09
1568017424 John Hernandez Nurse Practitioner 1721 Saemann Ave, Sheboygan, WI 53081-2342 2019-08-07
1962064436 Courtney F Klatt Nurse Practitioner 1902 Mead Ave, Sheboygan, WI 53081-6140 2019-07-03
1891259917 Debra A Wollert Nurse Practitioner 3711 S Taylor Dr, Sheboygan, WI 53081-8495 2019-01-23
1386180362 Amy Sue Gumieny Nurse Practitioner 1411 N Taylor Dr, Sheboygan, WI 53081-3043 2017-01-13
1508319344 Allison Schmitt Nurse Practitioner 2629 N 7th St, Sheboygan, WI 53083-4932 2016-07-28
1568915650 Julie A Reichle Nurse Practitioner 2629 N 7th St, Sheboygan, WI 53083-4932 2016-07-26
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Competitor

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City SHEBOYGAN
Zip Code 53081

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Dataset Information

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.

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