Provider Demographics
NPI:1619590239
Name:HANNA, LESLIE MORGANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MORGANNE
Last Name:HANNA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 SW ASBURY DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4466
Mailing Address - Country:US
Mailing Address - Phone:785-270-0197
Mailing Address - Fax:
Practice Address - Street 1:2902 SW ASBURY DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4466
Practice Address - Country:US
Practice Address - Phone:785-270-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02409363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant