Provider Demographics
NPI:1699034280
Name:HEINRICHS, LEANN (MD)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:HEINRICHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:NE
Mailing Address - Zip Code:68370-2019
Mailing Address - Country:US
Mailing Address - Phone:402-768-4614
Mailing Address - Fax:402-768-4667
Practice Address - Street 1:120 PARK AVE
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:NE
Practice Address - Zip Code:68370-2019
Practice Address - Country:US
Practice Address - Phone:402-768-4614
Practice Address - Fax:402-768-4667
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine