Provider Demographics
NPI:1477939361
Name:LEONHARDT, ANALIESA MARIE (CNM, DNP)
Entity Type:Individual
Prefix:
First Name:ANALIESA
Middle Name:MARIE
Last Name:LEONHARDT
Suffix:
Gender:F
Credentials:CNM, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 W 1000 N
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-4383
Mailing Address - Country:US
Mailing Address - Phone:801-473-6841
Mailing Address - Fax:
Practice Address - Street 1:201 W LAYTON PKWY STE 2B
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-3692
Practice Address - Country:US
Practice Address - Phone:801-543-6850
Practice Address - Fax:801-543-6868
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1645261163W00000X
UT8377579-3102163W00000X
COC-APN.0000396-C-CNM367A00000X
UT8377579-4402363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife