Provider Demographics
NPI:1104366806
Name:ALBRECHT, LEAH M (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:M
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3330
Mailing Address - Country:US
Mailing Address - Phone:307-682-8110
Mailing Address - Fax:307-685-1193
Practice Address - Street 1:1304 W 4TH ST
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3330
Practice Address - Country:US
Practice Address - Phone:307-682-8110
Practice Address - Fax:307-685-1193
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY39183.1599363LW0102X
SDCP001163363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health