Provider Demographics
NPI:1093017246
Name:CURTISS, LEIGHA MARIE (PHARM D/ RPH)
Entity Type:Individual
Prefix:
First Name:LEIGHA
Middle Name:MARIE
Last Name:CURTISS
Suffix:
Gender:F
Credentials:PHARM D/ RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1861
Mailing Address - Street 2:
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-1861
Mailing Address - Country:US
Mailing Address - Phone:402-578-1822
Mailing Address - Fax:928-729-8348
Practice Address - Street 1:7 ROUTE 12
Practice Address - Street 2:
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504-2325
Practice Address - Country:US
Practice Address - Phone:928-729-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-20
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13394183500000X
AZSO18253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ108397569OtherNDPCP