Individual provider Active NPI

Leslie Dawn Bryant, RN

  • Long-Term Care Clinical Nurse Specialist
  • Bloomington, IN
National Provider Identifier
1629647631
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long-Term Care Clinical Nurse SpecialistTaxonomy code 364SL0600X
License
28247726A Issued in IN
Practice address
3043 N Lintel Dr
Bloomington, IN 47404-8945
Phone
(812) 333-7622
NPI assigned
Jun 23, 2021
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long-Term Care Clinical Nurse Specialist 364SL0600X 28247726A IN Primary

Addresses

Primary practice location

3043 N Lintel Dr
Bloomington, IN 47404-8945

Mailing address

3043 N Lintel Dr
Bloomington, IN 47404-8945

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28247726AINMDLong-Term Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1629647631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 N LINTEL DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 N LINTEL DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048945",
            "telephone_number": "812-333-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "LESLIE",
        "middle_name": "DAWN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SL0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Long-Term Care",
            "state": "IN",
            "license": "28247726A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.