Individual provider Active NPI

Mary Lou Leitner, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1730161829
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN017399 Issued in AZ
Practice address
839 W Congress St
Tucson, AZ 85745-2819
Phone
(520) 792-9890
Fax
(520) 670-3816
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN017399 AZ Primary

Addresses

Primary practice location

839 W Congress St
Tucson, AZ 85745-2819

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 792-9890

Other identifiers 1

IdentifierTypeStateIssuer
760076MedicaidAZ

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN017399AZMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730161829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-792-9890",
            "fax_number": "520-670-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-792-9890",
            "fax_number": "520-670-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITNER",
        "first_name": "MARY",
        "middle_name": "LOU",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN017399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "760076",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.