Provider Demographics
NPI:1922605427
Name:GIFFORD, LEIA LYNN
Entity Type:Individual
Prefix:MRS
First Name:LEIA
Middle Name:LYNN
Last Name:GIFFORD
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:PO BOX 8397
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52408-8397
Mailing Address - Country:US
Mailing Address - Phone:760-468-4074
Mailing Address - Fax:
Practice Address - Street 1:4215 LEWIS ACCESS
Practice Address - Street 2:STE 700
Practice Address - City:CENTER POINT
Practice Address - State:IA
Practice Address - Zip Code:52213-5221
Practice Address - Country:US
Practice Address - Phone:760-468-4074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide