Provider Demographics
NPI:1093359523
Name:BUFFALOE, LEANNE MARIE (MSN, APRN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:MARIE
Last Name:BUFFALOE
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-AC
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:MARIE
Other - Last Name:PETTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, CPNP-AC
Mailing Address - Street 1:16132 COWAN RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77517-2654
Mailing Address - Country:US
Mailing Address - Phone:713-859-3873
Mailing Address - Fax:
Practice Address - Street 1:200 BLOSSOM ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4204
Practice Address - Country:US
Practice Address - Phone:832-632-7697
Practice Address - Fax:832-632-9007
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143733363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics