Susan Ruth Leibold, RN, MSSN, CNS-P

Primary specialty

Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X

License

624693 Issued in TX

Practice address

2222 Welborn St
4TH Floor
Dallas, TX 75219-3924

Phone

(214) 559-7860

Fax

(214) 559-7835

NPI assigned

Jun 8, 2012

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

Registered Nurse

State licenses

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1700148509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "address_2": "4TH FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-7860",
            "fax_number": "214-559-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "address_2": "4TH FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-7860",
            "fax_number": "214-559-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOLD",
        "first_name": "SUSAN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "RN, MSSN, CNS-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TX",
            "license": "624693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Lei
• Anna Leib
• Amber Leible
• Alexandra Leibold, MS, RD, LD
• Robert Leibold, LAT
• Evan Leibrock, DMD
• Rachel Leidner, M.D.
• James Freeman Leifeste, MD
• Madeline Porter Leifeste
• Ryan A Leiker, PH.D., MA

• Pediatric Clinical Nurse Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.