Individual provider Active NPI

Debra L Lesslie, CNNP

  • Neonatal Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1346434461
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
R1583270 Issued in MN
Practice address
347 North Smith Avenue, 70-505
Children's Specialty Clinic Nicu
St. Paul, MN 55102
Phone
(651) 220-6210
Fax
(651) 220-7777
NPI assigned
Aug 31, 2007
Last updated
Sep 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R1583270 MN Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X R1583270 MN

Addresses

Primary practice location

347 North Smith Avenue, 70-505
Children's Specialty Clinic Nicu
St. Paul, MN 55102

Mailing address

2910 Centre Pointe Dr
Mail Stop 35-121a
Roseville, MN 55113-1182
Phone (651) 855-2327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1583270MNMDCritical Care Neonatal Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1346434461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR",
            "address_2": "MAIL STOP 35-121A",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131182",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 NORTH SMITH AVENUE, 70-505",
            "address_2": "CHILDREN'S SPECIALTY CLINIC NICU",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-220-6210",
            "fax_number": "651-220-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSLIE",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "CNNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "R1583270",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MN",
            "license": "R1583270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.