Provider Demographics
NPI:1700164886
Name:LEONARD, MARCIA ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ANN
Last Name:LEONARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 47TH STREET PL
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8423
Mailing Address - Country:US
Mailing Address - Phone:308-991-0838
Mailing Address - Fax:308-865-2920
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2926
Practice Address - Country:US
Practice Address - Phone:308-865-7890
Practice Address - Fax:308-865-2920
Is Sole Proprietor?:No
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily