Provider Demographics
NPI:1114199981
Name:FRANK, LEAH M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:M
Last Name:FRANK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LEAH
Other - Middle Name:K
Other - Last Name:MCCARRAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-7900
Mailing Address - Fax:757-624-2254
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7900
Practice Address - Fax:757-624-2254
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002604363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1114199981Medicaid
VA10032469POtherSENTARA/OPTIMA
VAPAROtherCORVEL/CORCARE
VA-010OtherTRICARE/CHAMPUS
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VA10032469POtherSENTARA/OPTIMA