Dietra A Leastman, APRN
Individual provider Active NPI Neonatal Nurse Practitioner · Apo, KS
NPI 1124384995 · NPPES record last updated Sep 21, 2022
Key facts
- NPI
- 1124384995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal Nurse Practitioner 363LN0000X
- License
- 75393 (KS)
- Practice address
- Landstuhl Regional Medical Center Unit 33100
Apo, KS 09180-3100 - Phone
- (314) 590-5876
- NPI assigned
- Apr 6, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75393 | KS | MD | Neonatal Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 75393 | KS | Yes |
Addresses
Primary practice location
Landstuhl Regional Medical Center Unit 33100
Apo, KS 09180-3100
Mailing address
Landstuhl Regional Medical Center Unit 33100
Apo, KS 09180
Phone (314) 590-5876
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.