MEDICARE: SHAUNA ANN LEONARD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	374304-1206	UT

General Provider Information

NPI Number	:	1598707820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNA ANN LEONARD PA-C

Provider Business Mailing Address
First Line	:	4640 HOLLIDAY VILLAGE PLZ STE 101
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5288
Country	:	US
Telephone Number	:	801-878-9976
Fax Number	:	720-853-5495

Provider Business Practice Location Address
First Line	:	4640 HOLLIDAY VILLAGE PLZ STE 101
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5288
Country	:	US
Telephone Number	:	801-878-9976
Fax Number	:	720-853-5495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/13/2026

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Directions to “ SHAUNA ANN LEONARD PA-C” Practice Location

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