Healthcare Provider Details

I. General information

NPI: 1477939361
Provider Name (Legal Business Name): ANALIESA MARIE LEONHARDT CNM, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W LAYTON PKWY STE 2B
LAYTON UT
84041-3692
US

IV. Provider business mailing address

1349 W 1000 N
FARR WEST UT
84404-4383
US

V. Phone/Fax

Practice location:
  • Phone: 801-543-6850
  • Fax: 801-543-6868
Mailing address:
  • Phone: 801-473-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1645261
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number8377579-3102
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberC-APN.0000396-C-CNM
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number8377579-4402
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: