Provider Demographics
NPI:1417291170
Name:LEANO, ANYLOU (DNP,FNP,RN)
Entity Type:Individual
Prefix:
First Name:ANYLOU
Middle Name:
Last Name:LEANO
Suffix:
Gender:F
Credentials:DNP,FNP,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92546
Mailing Address - Country:US
Mailing Address - Phone:951-925-3600
Mailing Address - Fax:951-925-4600
Practice Address - Street 1:1264 E LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4445
Practice Address - Country:US
Practice Address - Phone:951-925-3600
Practice Address - Fax:951-925-4600
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily