Provider Demographics
NPI:1538102520
Name:LEEN, GAYLE CHRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:CHRISTINE
Last Name:LEEN
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:CENTRACARE CLINIC ST JOHN'S
Mailing Address - Street 2:2850 ABBEY PLAZA HLTHC 109
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56321
Mailing Address - Country:US
Mailing Address - Phone:320-656-7105
Mailing Address - Fax:320-200-3247
Practice Address - Street 1:CENTRACARE CLINIC ST JOHN'S
Practice Address - Street 2:2850 ABBEY PLAZA HLTHC 109
Practice Address - City:COLLEGEVILLE
Practice Address - State:MN
Practice Address - Zip Code:56321
Practice Address - Country:US
Practice Address - Phone:320-656-7105
Practice Address - Fax:320-200-3247
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN9471363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant