Provider Demographics
NPI:1578377958
Name:LEEK, AMANDA V
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:V
Last Name:LEEK
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:PO BOX 138
Mailing Address - Street 2:
Mailing Address - City:PEETZ
Mailing Address - State:CO
Mailing Address - Zip Code:80747-0138
Mailing Address - Country:US
Mailing Address - Phone:970-580-3576
Mailing Address - Fax:
Practice Address - Street 1:925 10TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1609
Practice Address - Country:US
Practice Address - Phone:308-524-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant