MEDICARE: JENNIFER LEGGETT NP

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	363LA2100X	Acute Care Nurse Practitioner	556006	CA

General Provider Information

NPI Number	:	1831189745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEGGETT NP

Provider Business Mailing Address
First Line	:	425 EUCLID AVE
Second Line	:	APT 3
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-2642
Country	:	US
Telephone Number	:	415-752-7796
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 POTRERO AVE
Second Line	:	ROOM 3B13
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3518
Country	:	US
Telephone Number	:	415-206-4073
Fax Number	:

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/08/2007

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