MEDICARE: DANA K LESHOK CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP025680	PA
2	363LF0000X	Family Nurse Practitioner	SP013115	PA
3	163W00000X	Registered Nurse	RN524082L	PA

General Provider Information

NPI Number	:	1659705861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA K LESHOK CRNP

Provider Business Mailing Address
First Line	:	4 CENTRE DR
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9683
Country	:	US
Telephone Number	:	717-208-2096
Fax Number	:	717-283-4198

Provider Business Practice Location Address
First Line	:	4 CENTRE DR
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9683
Country	:	US
Telephone Number	:	717-208-2096
Fax Number	:	717-283-4198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2013
Last Update Date	:	03/02/2026

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