Jody Leise, APRN, CNS

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

24 Issued in MN

Practice address

500 W Grant St
Lake City, MN 55041-1143

Phone

(651) 345-6711

NPI assigned

Dec 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1346951233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 SOUTHVIEW RDG",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550667160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W GRANT ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411143",
            "telephone_number": "651-345-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISE",
        "first_name": "JODY",
        "credential": "APRN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MN",
            "license": "24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Alan Knudsen, DDS
• McKenzie Marie Koch, OTD, OTR/L
• Lake City #813
• Lake City Chiropractic, LTD.
• Lake City Dental P.L.L.C.
• Katherine Lillie Lofberg, FNP-C
• Ann Marie Lowe, M.D.
• Reid Lundell
• Mayo Clinic Health System-Lake City
• Mayo Clinic Health System-Lake City

• All providers in Lake City, MN
• Adult Health Clinical Nurse Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.