Provider Demographics
NPI:1588478556
Name:JOINER, LERESSA MARIE
Entity type:Individual
Prefix:
First Name:LERESSA
Middle Name:MARIE
Last Name:JOINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LERESSA
Other - Middle Name:MARIE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3331 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3509
Mailing Address - Country:US
Mailing Address - Phone:402-320-8850
Mailing Address - Fax:
Practice Address - Street 1:3331 N 53RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3509
Practice Address - Country:US
Practice Address - Phone:402-320-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No372600000XNursing Service Related ProvidersAdult Companion