| NPI | 1932374725 |
|---|---|
| Former Name | AUTUMN LEIGH LEITZKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 223185-1) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: WI 150839-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 4837-33) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2014-12-16 |