Provider Demographics
NPI:1790783512
Name:CHANDLER, LEIGH ANNE (GNP)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH ANNE
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4942
Mailing Address - Country:US
Mailing Address - Phone:585-355-4729
Mailing Address - Fax:
Practice Address - Street 1:505 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2251
Practice Address - Country:US
Practice Address - Phone:585-546-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340696-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RB7447Medicare UPIN