Most Relevant Information
Provider Data
| NPI Number: | 1003476102 |
| Provider Name: | JELKA LEEDLE REGISTERED NURSE |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 196481-30 |
Most Important Dates
| Enumeration Date: | 06/19/2019 |
| Last Updated: | 04/23/2021 |
Provider Practice Location
N891 STATE ROAD 120
LAKE GENEVA
WI
531474224
Practice Location Phone/Fax
| Phone: | 6083226564 |
| Fax: |
Provider Mailing Location
N891 STATE ROAD 120
LAKE GENEVA
WI
531474224
Provider Mailing Phone/Fax
| Phone: | 6083226564 |
| Fax: |