Provider Demographics
NPI:1902102122
Name:HEMMER, LEANNE MARIE
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:MARIE
Last Name:HEMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6937 GRACEFUL CLOUD AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4981
Mailing Address - Country:US
Mailing Address - Phone:406-671-3571
Mailing Address - Fax:
Practice Address - Street 1:2775 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5631
Practice Address - Country:US
Practice Address - Phone:702-685-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-05
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner