1336385269 NPI number — MRS. JANEY NICOLE LEACHMAN-HAMMONS NP-C

Table of content: MRS. JANEY NICOLE LEACHMAN-HAMMONS NP-C (NPI 1336385269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336385269 NPI number — MRS. JANEY NICOLE LEACHMAN-HAMMONS NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEACHMAN-HAMMONS
Provider First Name:
JANEY
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEACHMAN
Provider Other First Name:
JANEY
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP NP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336385269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 404
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEILING
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73663-0404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-922-4406
Provider Business Mailing Address Fax Number:
580-922-4890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
204 N MAIN SEILING, OK 73663-0404
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEILING
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73663-0404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-362-0943
Provider Business Practice Location Address Fax Number:
303-353-1969
Provider Enumeration Date:
12/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  792436 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 81466 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 081466 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)