Leonor, Ivelisse E

Leonor, Ivelisse E is an individual health care provider with primary practice located at 1234 Napier Ave , Saint Joseph MI 49085. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Leonor, Ivelisse E can be contacted via phone (269) 985-4632.

Contact Information

Primary practice address
1234 Napier Ave Saint Joseph MI 49085
Phone: (269) 985-4632
Fax: (269) 985-4523
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28162828A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003297A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704291709 Michigan

Profile Details

NPI number 1104146042
LBN Legal business name Leonor, Ivelisse E
Credentials FAMILY NURSE PRACTIO
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2010
Last updated Aug 1st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104146042 NPPES
Indiana Other 000000669053 ANTHEM
Indiana Other 71003297B ANTHEM
Indiana MEDICAID 200989980 ANTHEM
Indiana Other 28162828A ANTHEM
Indiana Other 71003297A ANTHEM
Indiana MEDICAID 1104146942 ANTHEM

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