Provider Demographics
NPI:1285865659
Name:LELAND, SUZANNE K (CNP, APRN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:K
Last Name:LELAND
Suffix:
Gender:F
Credentials:CNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8251 COLUMBINE RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7610
Mailing Address - Country:US
Mailing Address - Phone:952-941-1266
Mailing Address - Fax:
Practice Address - Street 1:8251 COLUMBINE RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7610
Practice Address - Country:US
Practice Address - Phone:952-941-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR156567-0363LF0000X
MNR1565670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily