Healthcare Provider Details

I. General information

NPI: 1992521454
Provider Name (Legal Business Name): KRISTINA LEINHEISER MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 MARNE HWY
MOORESTOWN NJ
08057-3073
US

IV. Provider business mailing address

770 MARNE HWY
MOORESTOWN NJ
08057-3073
US

V. Phone/Fax

Practice location:
  • Phone: 609-864-6378
  • Fax:
Mailing address:
  • Phone: 401-431-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15225600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: