Provider Demographics
NPI:1730811019
Name:ANDERSON, LEAH MICHELLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MICHELLE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:366 W LAKE MEAD PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7287
Practice Address - Country:US
Practice Address - Phone:702-359-5210
Practice Address - Fax:702-997-0475
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV875832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily