Doctor Name: | JUDY ANN LEACH |
NPI Number: | 1790747525 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | A01000 |
Business Practice Address: | 807 E 9th St Rector, AR - 724612406 |
Business Phone Number: | 8705953527 |
Business Fax Number: | 8702402019 |
Mailing Address: | Po Box 272, RECTOR |
State: | AR |
Postal Code: | 724610272 |
Phone Number: | 8705953527 |
Fax Number: | 8702402019 |
NPI Enumeration Date: | 04/05/2006 |
NPI Last Update Date: | 03/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A01000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |