Provider Demographics
NPI:1659649879
Name:COY, LEANNA T (FNP)
Entity Type:Individual
Prefix:MS
First Name:LEANNA
Middle Name:T
Last Name:COY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 ROWE STREET
Mailing Address - Street 2:PO BOX 176
Mailing Address - City:WHEELER
Mailing Address - State:OR
Mailing Address - Zip Code:97147
Mailing Address - Country:US
Mailing Address - Phone:800-368-5182
Mailing Address - Fax:
Practice Address - Street 1:230 ROWE RD
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:OR
Practice Address - Zip Code:97147-0035
Practice Address - Country:US
Practice Address - Phone:008-368-5182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201392655NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily