LEANDRA BIBIANA BAZAN

GREELEY, CO
NPI1407947286
Other NameLEANDRA BIBIANA NOSSA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CO  PA0005128)
Additional Taxonomies363A00000X Physician Assistant
(Licence: FL  PA9103879)
246ZA2600X Specialist/Technologist, Other, Art, Medical
(Licence: FL  TN35171)
Enumeration Date2006-09-27
Last Update Date2018-11-28
Business Address
LEANDRA BIBIANA BAZAN PA-C, MT
1900 16TH ST
GREELEY, CO 80631
Phone number: 970-350-2426
Mailing Address
LEANDRA BIBIANA BAZAN PA-C, MT
1900 16TH ST
GREELEY, CO 80631-5114
Phone number: 970-350-2426