Provider Demographics
NPI:1891955423
Name:SIEGFRIED, LEAH M (PA-C)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:POLLASTRINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2355
Mailing Address - Country:US
Mailing Address - Phone:515-248-1447
Mailing Address - Fax:515-248-1440
Practice Address - Street 1:1200 UNIVERSITY AVE STE 120
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2355
Practice Address - Country:US
Practice Address - Phone:515-248-1500
Practice Address - Fax:515-248-1510
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002709207Q00000X, 363A00000X
IA089704363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine