Provider Demographics
NPI:1861728453
Name:LEAMY, FELVA COLLIE (PA-C)
Entity type:Individual
Prefix:
First Name:FELVA
Middle Name:COLLIE
Last Name:LEAMY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 FAIRBANKS ST STE A
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4165
Mailing Address - Country:US
Mailing Address - Phone:907-561-3488
Mailing Address - Fax:907-562-3488
Practice Address - Street 1:3300 FAIRBANKS ST STE A
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4165
Practice Address - Country:US
Practice Address - Phone:907-561-3488
Practice Address - Fax:907-562-3488
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1101363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1583402Medicaid
AKK165028Medicare PIN