Jennifer Alice Leisegang, RN, MSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN00148274 Issued in WA

Practice address

4745 N Golf Course Dr
Blaine, WA 98230-6818

Phone

(360) 820-4349

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Alice Sale Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1912064007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 N GOLF COURSE DR",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982306818",
            "telephone_number": "360-820-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 N GOLF COURSE DR",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982306818",
            "telephone_number": "360-820-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISEGANG",
        "first_name": "JENNIFER",
        "middle_name": "ALICE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00148274",
            "primary": true
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "WA",
            "license": "RN00148274",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SALE",
            "middle_name": "ALICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wenunah Krystal Lance
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• Trista Rawlings Lawrence, LMP
• Candace Lawson-Crossfield, MA, LMHC
• Choong Hyun Lee, D.M.D
• Alan Lerma
• Benjamin Li, PHARMACIST
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• Amy Maria Lindeman, MEDICAL ASSIST.
• Allison B Mason

• Registered Nurse in Blaine, WA
• Providers in Blaine, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.