Provider Demographics
NPI:1033397575
Name:LEENHEER, REBECCA SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUZANNE
Last Name:LEENHEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUZANNE
Other - Last Name:DOHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:303 MULBERRY ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4739
Mailing Address - Country:US
Mailing Address - Phone:505-243-9739
Mailing Address - Fax:505-842-0650
Practice Address - Street 1:303 MULBERRY ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4739
Practice Address - Country:US
Practice Address - Phone:505-243-9739
Practice Address - Fax:505-842-0650
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0769207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology