Leah Kathleen Bond

Individual provider Active NPI Adult Health Clinical Nurse Specialist · Rolla, MO

NPI 1629460878 · NPPES record last updated Aug 22, 2019

Key facts

NPI
1629460878
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Clinical Nurse Specialist 364SA2200X
License
2014038710 (MO)
Practice address
600 Blues Lake Pkwy
Rolla, MO 65401-8022
Phone
(573) 364-8822
Fax
(573) 341-5969
NPI assigned
Feb 25, 2015
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2014038710MOMDAdult Health Clinical Nurse Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 2014043711 MO
Adult Health Clinical Nurse Specialist 364SA2200X 2014038710 MO Yes

Addresses

Primary practice location

600 Blues Lake Pkwy
Rolla, MO 65401-8022

Mailing address

600 Blues Lake Pkwy
Rolla, MO 65401-8022
Phone (573) 364-8822

Other names

  • Leah Kathleen Chmielewski Former name

Other providers in Rolla, MO

All providers in Rolla, MO · Adult Health Clinical Nurse Specialist in Missouri

Sources for this page

Verify at the official NPI Registry.