Provider Demographics
NPI:1225305667
Name:GEESTON-ENUM, LEAH (RN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:GEESTON-ENUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:GEESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 S REYNOLDS ST APT 208
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-4460
Mailing Address - Country:US
Mailing Address - Phone:703-980-3810
Mailing Address - Fax:703-566-2075
Practice Address - Street 1:240 S REYNOLDS ST APT 208
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-980-3810
Practice Address - Fax:703-566-2075
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001187067163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health