Basic Information
| Provider Information | |||||||||
| NPI: | 1457839888 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEECH | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | E. B. | ||||||||
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| Credential: | AGACNP-BC, CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178516969 | ||||||||
| Practice Location | |||||||||
| Address1: | 169 MARTIN AVE # 1002 | ||||||||
| Address2: | |||||||||
| City: | EPHRATA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175221724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177214740 | ||||||||
| FaxNumber: | 7177386872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2018 | ||||||||
| LastUpdateDate: | 02/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | SP018927 | PA | N | Allopathic & Osteopathic Physicians | Hospitalist | 363LA2100X | SP018927 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.