Individual
MRS. DONNA MARIE LEYDET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3200 WESTHILL DR, SUITE 200, WAUSAU, WI 54401-4705
(715) 847-2019
(715) 847-2667
Mailing address
3200 WESTHILL DR, SUITE 200, WAUSAU, WI 54401-4705
(715) 847-2019
(715) 847-2667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
621-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42928900
—
WI
01
—
56842
SECURITY HEALTH PLAN
WI
Enumeration date
08/31/2006
Last updated
03/24/2008
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