Provider Demographics
NPI:1851367296
Name:LEACH, JULIE CARPENTER (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:CARPENTER
Last Name:LEACH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 GOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-544-3700
Mailing Address - Fax:
Practice Address - Street 1:690 GOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN280846L363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1150107OtherAETNA-HMO
PA253305OtherHEALTHAMERICA
PA50056086OtherCAPITAL BLUE CROSS
PA50056086OtherKEYSTONE HEALTH PLAN CENTRAL
PA7539780OtherAETNA-NON HMO