Provider Demographics
NPI:1225001647
Name:SCHEMMEL, LEASHA
Entity Type:Individual
Prefix:
First Name:LEASHA
Middle Name:
Last Name:SCHEMMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 WEST 42ND ST #17
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132D FIGHTER WING IAANG/132MDG
Practice Address - Street 2:3100 MCKINLEY AVE
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2799
Practice Address - Country:US
Practice Address - Phone:563-388-0867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine