Provider Demographics
NPI:1679897086
Name:LEEMAN, ROBIN T (PA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:T
Last Name:LEEMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:155 PRINTERS PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-6100
Mailing Address - Country:US
Mailing Address - Phone:719-635-5657
Mailing Address - Fax:719-578-9014
Practice Address - Street 1:155 PRINTERS PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-6100
Practice Address - Country:US
Practice Address - Phone:719-635-5657
Practice Address - Fax:719-578-9014
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO805OtherLICENSE