Provider Demographics
NPI:1346795069
Name:HEMMINGSEN, LEAH ANN
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:ANN
Last Name:HEMMINGSEN
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 1:107 KAISER AVE N
Mailing Address - Street 2:
Mailing Address - City:FOSSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56542-1224
Mailing Address - Country:US
Mailing Address - Phone:218-435-1454
Mailing Address - Fax:
Practice Address - Street 1:107 KAISER AVE N
Practice Address - Street 2:
Practice Address - City:FOSSTON
Practice Address - State:MN
Practice Address - Zip Code:56542-1224
Practice Address - Country:US
Practice Address - Phone:218-435-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy