Provider Demographics
NPI:1356398697
Name:KEARNS, LELANYA (MD)
Entity type:Individual
Prefix:
First Name:LELANYA
Middle Name:
Last Name:KEARNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 SAMARITAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4107
Mailing Address - Country:US
Mailing Address - Phone:408-871-3400
Mailing Address - Fax:408-871-5225
Practice Address - Street 1:2585 SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4107
Practice Address - Country:US
Practice Address - Phone:408-871-3400
Practice Address - Fax:408-871-5225
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38880207V00000X
CAA90034207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64086325Medicaid
OH2513766Medicaid
IN200501440Medicaid
OH2513766Medicaid