Provider Demographics
NPI:1780844860
Name:YERKOVICH, LEIGH ANN (OTR)
Entity Type:Individual
Prefix:
First Name:LEIGH ANN
Middle Name:
Last Name:YERKOVICH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 SAGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-7459
Mailing Address - Country:US
Mailing Address - Phone:307-371-6940
Mailing Address - Fax:
Practice Address - Street 1:1715 HITCHING POST DR
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5783
Practice Address - Country:US
Practice Address - Phone:307-872-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-1043174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist