Provider Demographics
NPI:1730648759
Name:GALVAN, LEANNE GROVER (DNP, APRN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:GROVER
Last Name:GALVAN
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17030 LAKESIDE HILLS PLZ STE 102
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4656
Mailing Address - Country:US
Mailing Address - Phone:402-758-5800
Mailing Address - Fax:
Practice Address - Street 1:17030 LAKESIDE HILLS PLZ STE 102
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4656
Practice Address - Country:US
Practice Address - Phone:402-758-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112669363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner