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Individual

LYNN R LEYBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP, CNM

Contact information

Practice address
1008 N GRAND AVE, PUEBLO, CO 81003-2916
(719) 543-8711
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-5340

Taxonomy

Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
APN.0990713-NP
CO
367A00000X
Advanced Practice Midwife
119829
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02455340
CO
01
311836YLQP
MEDICARE PTAN
CO
Enumeration date
06/24/2006
Last updated
07/21/2022
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