Provider Demographics
NPI:1659521045
Name:GRONEMEYER, LEANNE RAE (APRN CNP CNS)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:RAE
Last Name:GRONEMEYER
Suffix:
Gender:F
Credentials:APRN CNP CNS
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Mailing Address - Street 1:41 MONTEBELLO RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1366
Mailing Address - Country:US
Mailing Address - Phone:719-545-2746
Mailing Address - Fax:719-542-9638
Practice Address - Street 1:41 MONTEBELLO RD
Practice Address - Street 2:SUITE 116
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001
Practice Address - Country:US
Practice Address - Phone:719-423-1500
Practice Address - Fax:719-542-9269
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2018-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN0992103-NP363LF0000X, 363LF0000X
OKR0074198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily