Healthcare Provider Details

I. General information

NPI: 1205345196
Provider Name (Legal Business Name): LEAH R HEMING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH R BEHYMER NP

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 COLLEGE AVE
QUINCY IL
62301-2600
US

IV. Provider business mailing address

1084 HEMINGWAY DR N
QUINCY IL
62305-9252
US

V. Phone/Fax

Practice location:
  • Phone: 217-214-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number277002305
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209016180
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209016180
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: