Provider Demographics
NPI:1750514121
Name:SANNER, LEAH CAROLYN (RN CNP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:CAROLYN
Last Name:SANNER
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 FARMDALE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTA
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2330 TROOP DR UNIT 102
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4531
Practice Address - Country:US
Practice Address - Phone:320-252-2803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1603545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily