Provider Demographics
NPI:1316219553
Name:MAIER, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MAIER
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 1:5616 460TH ST
Mailing Address - Street 2:
Mailing Address - City:PAULLINA
Mailing Address - State:IA
Mailing Address - Zip Code:51046-7516
Mailing Address - Country:US
Mailing Address - Phone:712-448-2000
Mailing Address - Fax:712-448-2005
Practice Address - Street 1:5616 460TH ST
Practice Address - Street 2:
Practice Address - City:PAULLINA
Practice Address - State:IA
Practice Address - Zip Code:51046-7516
Practice Address - Country:US
Practice Address - Phone:712-448-2000
Practice Address - Fax:712-448-2005
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-009074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily