Provider Demographics
NPI:1598052250
Name:METHENY, LEANN W (DNP, FNP-BC, NP-C)
Entity Type:Individual
Prefix:MS
First Name:LEANN
Middle Name:W
Last Name:METHENY
Suffix:
Gender:F
Credentials:DNP, FNP-BC, NP-C
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 83
Mailing Address - Street 2:
Mailing Address - City:ELM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72728-0083
Mailing Address - Country:US
Mailing Address - Phone:479-879-3400
Mailing Address - Fax:
Practice Address - Street 1:700 N 40TH ST STE B
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0633
Practice Address - Country:US
Practice Address - Phone:479-318-2828
Practice Address - Fax:479-318-2683
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner