Provider Demographics
NPI:1649825050
Name:ECHEVERRIA, LESLIE (RN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12931 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6015
Mailing Address - Country:US
Mailing Address - Phone:402-301-3712
Mailing Address - Fax:531-299-2319
Practice Address - Street 1:8210 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68147-1705
Practice Address - Country:US
Practice Address - Phone:531-299-2300
Practice Address - Fax:531-299-2319
Is Sole Proprietor?:No
Enumeration Date:2019-08-03
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE79691163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool