Provider Demographics
NPI:1417617960
Name:LEIGH, DESIREE ARIELLE (APRN)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:ARIELLE
Last Name:LEIGH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8690 POINT CYPRESS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5409
Mailing Address - Country:US
Mailing Address - Phone:407-566-1616
Mailing Address - Fax:
Practice Address - Street 1:8690 POINT CYPRESS DR STE 11
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-5408
Practice Address - Country:US
Practice Address - Phone:407-566-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-26
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily