Healthcare Provider Details

I. General information

NPI: 1780713487
Provider Name (Legal Business Name): GERALDINE HARVEY-LEONARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 CENTRE POINTE DR SUITE 400
WEST CHESTER OH
45069-4874
US

IV. Provider business mailing address

4200 CAMARGO DR APT J
DAYTON OH
45415-3310
US

V. Phone/Fax

Practice location:
  • Phone: 937-831-0854
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number08788
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: