Basic Information
| Provider Information | |||||||||
| NPI: | 1942822283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEBBINS | ||||||||
| FirstName: | LEANNA | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 SW PINNACLE GLN | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320246354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3869848187 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3925 NW 43RD ST | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326064565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523711777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2020 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN9343822 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | APRN11007454 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.