Provider Demographics
NPI:1912996323
Name:LEIF, PAULA M (CRNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:LEIF
Suffix:
Gender:F
Credentials:CRNP
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Other - Last Name:
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Mailing Address - Street 1:511 RUIN CREEK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5919
Mailing Address - Country:US
Mailing Address - Phone:252-430-7700
Mailing Address - Fax:252-430-8612
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:252-430-7700
Practice Address - Fax:252-430-8612
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC79092363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS40416Medicare UPIN