Provider Demographics
NPI:1699379677
Name:FRANCISCO, LEANNA MORGAN
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:MORGAN
Last Name:FRANCISCO
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 1:31 E VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-2822
Mailing Address - Country:US
Mailing Address - Phone:276-669-4640
Mailing Address - Fax:276-669-0742
Practice Address - Street 1:31 E VALLEY DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-2822
Practice Address - Country:US
Practice Address - Phone:276-669-4640
Practice Address - Fax:276-669-0742
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist