Provider Demographics
NPI:1336578848
Name:ATTERBURY, LEANNA LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LEANNA
Middle Name:LYNN
Last Name:ATTERBURY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LEANNA
Other - Middle Name:LYNN
Other - Last Name:DOLLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:101 E ROSS
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67026
Mailing Address - Country:US
Mailing Address - Phone:320-584-2055
Mailing Address - Fax:620-584-2032
Practice Address - Street 1:2509 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2233
Practice Address - Country:US
Practice Address - Phone:785-623-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501657363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant