Provider Demographics
NPI:1083917256
Name:SOMMER, LEA MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LEA
Middle Name:MARIE
Last Name:SOMMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LEA
Other - Middle Name:MARIE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:987431 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-7431
Mailing Address - Country:US
Mailing Address - Phone:402-552-3549
Mailing Address - Fax:402-552-3311
Practice Address - Street 1:601 E 2ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NE
Practice Address - Zip Code:68045-1400
Practice Address - Country:US
Practice Address - Phone:402-685-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
NE1571363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical