Provider Demographics
NPI:1083853436
Name:LELAND, NECOLE A (APN)
Entity Type:Individual
Prefix:
First Name:NECOLE
Middle Name:A
Last Name:LELAND
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W LAKE MEAD PKWY
Mailing Address - Street 2:#B-18
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7055
Mailing Address - Country:US
Mailing Address - Phone:702-564-7213
Mailing Address - Fax:702-558-1522
Practice Address - Street 1:2821 W HORIZON RIDGE PKWY
Practice Address - Street 2:#101
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4427
Practice Address - Country:US
Practice Address - Phone:702-212-5889
Practice Address - Fax:702-212-5890
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN44821363LP0200X
NVAPN001113363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBQ079ZMedicare PIN