Provider Demographics
NPI:1215810296
Name:LEIBHART, LAURA LEANN
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEANN
Last Name:LEIBHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S N ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-3057
Mailing Address - Country:US
Mailing Address - Phone:308-870-1698
Mailing Address - Fax:
Practice Address - Street 1:47984 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-5054
Practice Address - Country:US
Practice Address - Phone:308-870-1698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion