Provider Demographics
NPI:1699131938
Name:LEAH ATKINSON, FNP, LLC
Entity type:Organization
Organization Name:LEAH ATKINSON, FNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:505-614-4528
Mailing Address - Street 1:HC 75 BOX 1091
Mailing Address - Street 2:
Mailing Address - City:LOS OJOS
Mailing Address - State:NM
Mailing Address - Zip Code:87551-9707
Mailing Address - Country:US
Mailing Address - Phone:505-614-4528
Mailing Address - Fax:
Practice Address - Street 1:HC 75 BOX 1091
Practice Address - Street 2:
Practice Address - City:LOS OJOS
Practice Address - State:NM
Practice Address - Zip Code:87551-9707
Practice Address - Country:US
Practice Address - Phone:505-614-4528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02560261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740621366OtherNPI