Provider Demographics
NPI:1073142386
Name:LEONHARDT, AMBER VALERIE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:VALERIE
Last Name:LEONHARDT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3832 E PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1838
Mailing Address - Country:US
Mailing Address - Phone:480-310-2924
Mailing Address - Fax:
Practice Address - Street 1:3271 E QUEEN CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8511
Practice Address - Country:US
Practice Address - Phone:480-550-3193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP240107363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health