Individual
LISA LEANNE HAUERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19550 E 39TH ST S STE 230, INDEPENDENCE, MO 64057-2309
(816) 795-6630
Mailing address
8612 NE 73RD CT, KANSAS CITY, MO 64158-4404
(816) 405-9414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2007033581
MO
363AS0400X
Surgical Physician Assistant
Primary
2007033581
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43727031
BCBS
MO
Enumeration date
10/02/2008
Last updated
05/11/2023
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