MEDICARE: MICHELE LEYDA

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	163W00000X	Registered Nurse	RN572873	PA

General Provider Information

NPI Number	:	1689038036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE LEYDA

Provider Business Mailing Address
First Line	:	435 DEEMS PARK RD
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1336
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 DEEMS PARK RD
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1336
Country	:	US
Telephone Number	:	724-809-1701
Fax Number	:

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

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	04/12/2016

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Directions to “ MICHELE LEYDA ” Practice Location

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