Provider Demographics
NPI:1447635305
Name:KNOWLES, LEANNE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:LEANNE
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854-3665
Mailing Address - Country:US
Mailing Address - Phone:334-756-5150
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854
Practice Address - Country:US
Practice Address - Phone:334-756-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-047449363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care