Provider Demographics
NPI:1407608953
Name:LEESON, EMELINA MARTA (CPM/LM)
Entity Type:Individual
Prefix:
First Name:EMELINA
Middle Name:MARTA
Last Name:LEESON
Suffix:
Gender:F
Credentials:CPM/LM
Other - Prefix:
Other - First Name:EMELINA
Other - Middle Name:MARTA
Other - Last Name:SPRANSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1417 DREWRY LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2101
Mailing Address - Country:US
Mailing Address - Phone:608-843-3204
Mailing Address - Fax:608-571-0021
Practice Address - Street 1:159 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5820
Practice Address - Country:US
Practice Address - Phone:608-843-3204
Practice Address - Fax:608-571-0021
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI328-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife