Basic Information
| Provider Information | |||||||||
| NPI: | 1861488900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEANY | ||||||||
| FirstName: | JANA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1380 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | BUSINESS OFFICE | ||||||||
| City: | ST GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356884755 | ||||||||
| FaxNumber: | 4356884002 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | ST GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352511000 | ||||||||
| FaxNumber: | 4356884002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2005 | ||||||||
| LastUpdateDate: | 12/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2001834405 | UT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 2001834405 | UT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 820151 | 05 | AZ | MEDICAID | D4281 | 05 | UT | MEDICAID | 200183440010 | 01 | UT | BLUE CROSS | OTHER |