Provider Demographics
NPI:1457594905
Name:HARKER, LEANNE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:HARKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3900
Mailing Address - Fax:517-913-3901
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3900
Practice Address - Fax:517-913-3901
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704131325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9572480OtherAETNA
MI5008708110OtherBLUE CROSS BLUE SHIELD
MI200000022319OtherPHP FAMILYCARE
MI200000022319OtherPHP
MI1056458OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1056458OtherMCLAREN HEALTH ADVANTAGE
MI1056458OtherMCLAREN HEALTH PLAN-MEDICAID
MIP00801395OtherRAILROAD MEDICARE
MI0N55170018OtherMEDICARE ADVANTAGE
MIP00801395OtherRAILROAD MEDICARE