Healthcare Provider Details

I. General information

NPI: 1861338188
Provider Name (Legal Business Name): LEAH ELIZABETH ROYE FNP STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 MOUNT VERNON HWY NE STE 200
SANDY SPRINGS GA
30328-4255
US

IV. Provider business mailing address

859 MOUNT VERNON HWY NE STE 200
SANDY SPRINGS GA
30328-4255
US

V. Phone/Fax

Practice location:
  • Phone: 808-853-8068
  • Fax:
Mailing address:
  • Phone: 808-853-8068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2461372
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: