Provider Demographics
NPI:1568848547
Name:COLLIGAN, LEAH MARIE (MSN, APN, CPNP-PC)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:MARIE
Last Name:COLLIGAN
Suffix:
Gender:F
Credentials:MSN, APN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2274
Practice Address - Country:US
Practice Address - Phone:608-263-3301
Practice Address - Fax:608-263-0530
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR209399363LP0200X
WI9125-33363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics