Provider Demographics
NPI:1619641677
Name:LEACH, HAILEY (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:LEACH
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7541 US HIGHWAY 87 E STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78263-2407
Mailing Address - Country:US
Mailing Address - Phone:210-648-9900
Mailing Address - Fax:
Practice Address - Street 1:7541 US HIGHWAY 87 E STE 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78263-2407
Practice Address - Country:US
Practice Address - Phone:210-648-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily