MEDICARE: LEANNA COLVIN RN

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	163WS0200X	School Registered Nurse	573655	NY

General Provider Information

NPI Number	:	1255298659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNA COLVIN RN

Provider Business Mailing Address
First Line	:	66 LETCHWORTH AVE
Second Line	:
City	:	AUBURN
State	:	NY
Zip	:	13021
Country	:	US
Telephone Number	:	315-255-8725
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 LETCHWORTH ST
Second Line	:
City	:	AUBURN
State	:	NY
Zip	:	13021-5535
Country	:	US
Telephone Number	:	315-255-8725
Fax Number	:

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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