Provider Demographics
NPI:1043209752
Name:LECHE, AMANDA RENEE (PA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:LECHE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:R
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:SUITE 300 REGIONAL HEALTHPLUS
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-2168
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1650 SKYLYN DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1047
Practice Address - Country:US
Practice Address - Phone:864-327-8060
Practice Address - Fax:864-327-8076
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1392363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1707PAMedicaid
SCSC13217628Medicare PIN
SC1707PAMedicaid