Provider Demographics
NPI:1861488900
Name:LEANY, JANA M (APRN)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:M
Last Name:LEANY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 E MEDICAL CENTER DRIVE
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790
Mailing Address - Country:US
Mailing Address - Phone:435-688-4755
Mailing Address - Fax:435-688-4002
Practice Address - Street 1:1380 E MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-251-1000
Practice Address - Fax:435-688-4002
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2001834405363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ820151Medicaid
UTD4281Medicaid
UT200183440010OtherBLUE CROSS
000698302Medicare ID - Type Unspecified
000060995Medicare PIN
UTD4281Medicaid