Provider Demographics
NPI:1548738503
Name:WEDDLE, LEIGH ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ANN
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WALNUT ST APT 421
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2450
Mailing Address - Country:US
Mailing Address - Phone:816-694-9163
Mailing Address - Fax:
Practice Address - Street 1:600 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-9730
Practice Address - Country:US
Practice Address - Phone:720-587-1002
Practice Address - Fax:720-587-1000
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist