Provider Demographics
NPI:1942822283
Name:STEBBINS, LEANNA BROOKE (APRN)
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:BROOKE
Last Name:STEBBINS
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 1:117 SW PINNACLE GLN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-6354
Mailing Address - Country:US
Mailing Address - Phone:386-984-8187
Mailing Address - Fax:
Practice Address - Street 1:3925 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4565
Practice Address - Country:US
Practice Address - Phone:352-371-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9343822363LF0000X
FLAPRN11007454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily