Provider Demographics
NPI:1588817753
Name:LEAHY, JANET (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:LEAHY
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILLVALE
Mailing Address - State:PA
Mailing Address - Zip Code:15209-1008
Mailing Address - Country:US
Mailing Address - Phone:412-398-4021
Mailing Address - Fax:
Practice Address - Street 1:138 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MILLVALE
Practice Address - State:PA
Practice Address - Zip Code:15209-1008
Practice Address - Country:US
Practice Address - Phone:412-398-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010020363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care