| Renee Leisen, FNP-C | |
|
12142 Business Park Blvd N, Champlin, MN 55316-4525 | |
| (952) 977-0500 | |
| Not Available |
| Full Name | Renee Leisen |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 12142 Business Park Blvd N, Champlin, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336872498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 2015284 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 9595 (Minnesota) | Primary |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Leisen, FNP-C 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () - | Renee Leisen, FNP-C 12142 Business Park Blvd N, Champlin, MN 55316-4525 Ph: (952) 977-0500 |
Mrs. Olitha Jamesetta Fofana, AGPCNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10911 Rhode Island Cir N, Champlin, MN 55316 Phone: 763-493-2947 | |
Ellen Hanson, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 763-236-0600 Fax: 763-236-0790 | |
Prince Nde Aloh, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 763-236-0600 | |
Holly M Jensrud, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 763-236-0600 Fax: 763-427-0790 | |
Stone Hamabwe Kabwe, CNP, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12142 Business Park Blvd N, Champlin, MN 55316 Phone: 952-977-0500 | |
Elissa Gemphel, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10920 River Pines Dr N, Champlin, MN 55316 Phone: 917-584-3834 | |
Magdalene Maghanga, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9440 Overlook Ct, Champlin, MN 55316 Phone: 763-316-9487 |