Provider Demographics
NPI:1912280199
Name:LEISING, LEAH ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:ANN
Last Name:LEISING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10674 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:GOWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14070-1344
Mailing Address - Country:US
Mailing Address - Phone:716-532-3325
Mailing Address - Fax:716-995-2125
Practice Address - Street 1:10674 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GOWANDA
Practice Address - State:NY
Practice Address - Zip Code:14070-1344
Practice Address - Country:US
Practice Address - Phone:716-532-3325
Practice Address - Fax:716-995-2125
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY445761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse