Provider Demographics
NPI:1508319120
Name:GOINS, LEAH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:GOINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 BERRYMANS LN
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6011
Mailing Address - Country:US
Mailing Address - Phone:410-833-4365
Mailing Address - Fax:
Practice Address - Street 1:906 BERRYMANS LN
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-6011
Practice Address - Country:US
Practice Address - Phone:410-833-4365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-31
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily