Individual
MRS. LEANNE R. COTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 FRONT ST, TANANA, AK 99777
(907) 366-7222
Mailing address
PO BOX 4, PLEVNA, MT 59344-0004
(406) 778-7750
(406) 772-5849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
170876
AK
363A00000X
Physician Assistant
36234
MT
363A00000X
Physician Assistant
PA0000001325
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170876
ALASKA MEDICAL LICENSE
AK
01
—
MEDPACLIC36234
MONTANA MEDICAL LICENSE
MT
01
—
PA0000001325
MEDICAL LICENSE NUMBER
TN
Enumeration date
08/24/2006
Last updated
06/17/2021
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