Healthcare Provider Details

I. General information

NPI: 1972086320
Provider Name (Legal Business Name): TIREANY LEAMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 N PRINCE ST
LANCASTER PA
17603-3085
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-553-5341
  • Fax: 717-869-6411
Mailing address:
  • Phone: 717-560-7917
  • Fax: 717-560-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN660066
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: