Healthcare Provider Details

I. General information

NPI: 1326492182
Provider Name (Legal Business Name): LEAH CHRISTINE HENKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH CHRISTINE ANDERSON MD

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 06/15/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 24TH AVE S STE 300
MINNEAPOLIS MN
55454-1437
US

IV. Provider business mailing address

606 24TH AVE S STE 300
MINNEAPOLIS MN
55454-1437
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-7111
  • Fax: 612-273-7112
Mailing address:
  • Phone: 612-273-7111
  • Fax: 612-273-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number67411
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: