Provider Demographics
NPI:1255068367
Name:LEIBBRANDT, CELESTE M
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:M
Last Name:LEIBBRANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BLANCHARD BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6681
Mailing Address - Country:US
Mailing Address - Phone:303-956-4592
Mailing Address - Fax:
Practice Address - Street 1:7410 BLANCHARD BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6681
Practice Address - Country:US
Practice Address - Phone:303-956-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider