Provider Demographics
NPI:1801215975
Name:SANCHEZ, LEIDY ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:LEIDY
Middle Name:ELIZABETH
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:LEIDY
Other - Middle Name:ELIZABETH
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:4721 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5610
Mailing Address - Country:US
Mailing Address - Phone:520-833-0315
Mailing Address - Fax:520-844-8251
Practice Address - Street 1:4721 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718
Practice Address - Country:US
Practice Address - Phone:520-833-0315
Practice Address - Fax:520-844-8251
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5496363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ908716Medicaid
AZAP5496OtherARIZONA BOARD OF NURSING