Provider Demographics
NPI:1851074033
Name:LEIER, TASHA LYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:LYN
Last Name:LEIER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:LYN
Other - Last Name:HEISLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 20TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6487
Mailing Address - Country:US
Mailing Address - Phone:701-837-1551
Mailing Address - Fax:
Practice Address - Street 1:1021 20TH AVE SW STE 113
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6487
Practice Address - Country:US
Practice Address - Phone:701-837-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR44069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily