Provider Demographics
NPI:1902044019
Name:CURLEY, LEANN
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:CURLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 971
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NM
Mailing Address - Zip Code:87347-0971
Mailing Address - Country:US
Mailing Address - Phone:505-863-6380
Mailing Address - Fax:505-863-6370
Practice Address - Street 1:2002 E HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4868
Practice Address - Country:US
Practice Address - Phone:505-863-6380
Practice Address - Fax:505-863-6370
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM47721804Medicaid