Provider Demographics
NPI:1235579558
Name:ROMANS-NICHOLS, LEANN RENEE (DVM)
Entity Type:Individual
Prefix:DR
First Name:LEANN
Middle Name:RENEE
Last Name:ROMANS-NICHOLS
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 W ROUTE 66
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-6297
Mailing Address - Country:US
Mailing Address - Phone:928-779-0148
Mailing Address - Fax:
Practice Address - Street 1:963 W ROUTE 66
Practice Address - Street 2:SUITE 230
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-6297
Practice Address - Country:US
Practice Address - Phone:928-779-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4705174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian