Provider Demographics
NPI:1093016578
Name:LESHOVSKY, KRISTINE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:LESHOVSKY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-1728
Mailing Address - Country:US
Mailing Address - Phone:507-359-2756
Mailing Address - Fax:507-354-1260
Practice Address - Street 1:6 NORTH MINNESOTA STREET
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1728
Practice Address - Country:US
Practice Address - Phone:507-359-2756
Practice Address - Fax:507-354-1260
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR193841-4164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse