Provider Demographics
NPI:1598367468
Name:LEISZ, SARINA LYNN
Entity Type:Individual
Prefix:
First Name:SARINA
Middle Name:LYNN
Last Name:LEISZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5279 SPRINGBORO RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9009
Mailing Address - Country:US
Mailing Address - Phone:513-315-2148
Mailing Address - Fax:
Practice Address - Street 1:5279 SPRINGBORO RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9009
Practice Address - Country:US
Practice Address - Phone:513-315-2148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker