MEDICARE: MS. LAURA A LEUENBERGER-BANKS FNP

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	363LF0000X	Family Nurse Practitioner	RN319869	OH
2	363LF0000X	Family Nurse Practitioner	COA10945NP	OH
3	363LF0000X	Family Nurse Practitioner	RX10945EX1	OH
4	363L00000X	Nurse Practitioner	COA101945NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679807911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA A LEUENBERGER-BANKS FNP

Provider Business Mailing Address
First Line	:	4850 SMITH RD STE 100A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2797
Country	:	US
Telephone Number	:	513-841-0777
Fax Number	:	513-841-0877

Provider Business Practice Location Address
First Line	:	4850 SMITH RD STE 100A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2797
Country	:	US
Telephone Number	:	513-841-0777
Fax Number	:	513-841-0877

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

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	03/12/2019

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Directions to “ MS. LAURA A LEUENBERGER-BANKS FNP” Practice Location

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