Provider Demographics
NPI:1114672037
Name:TROTMAN, LEANDRA PATRICE
Entity Type:Individual
Prefix:MRS
First Name:LEANDRA
Middle Name:PATRICE
Last Name:TROTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8643 DEN BARK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6554
Mailing Address - Country:US
Mailing Address - Phone:804-295-6917
Mailing Address - Fax:
Practice Address - Street 1:8643 DEN BARK DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6554
Practice Address - Country:US
Practice Address - Phone:804-295-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAC15582976171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator