Provider Demographics
NPI:1104468826
Name:HUTTO, LEANNA NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:NICOLE
Last Name:HUTTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 S TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3151
Mailing Address - Country:US
Mailing Address - Phone:470-364-7797
Mailing Address - Fax:
Practice Address - Street 1:183 S TAYLOR AVE UNIT 158
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-3150
Practice Address - Country:US
Practice Address - Phone:303-449-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0100169-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily