Healthcare Provider Details

I. General information

NPI: 1346163086
Provider Name (Legal Business Name): LAUREN KATHERINE LEITNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S GRAND AVE
IOWA CITY IA
52240
US

IV. Provider business mailing address

218 MELROSE CT
IOWA CITY IA
52246-2014
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-9847
  • Fax:
Mailing address:
  • Phone: 920-522-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: