Healthcare Provider Details
I. General information
NPI: 1508387929
Provider Name (Legal Business Name): LORI ANN LEACH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/06/2017
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date: 09/29/2025
Reactivation Date: 10/29/2025
III. Provider practice location address
50 PLEASANT GROVE RD
MECHANICSBURG PA
17050
US
IV. Provider business mailing address
50 PLEASANT GROVE RD
MECHANICSBURG PA
17050
US
V. Phone/Fax
- Phone: 717-483-2203
- Fax: 717-703-2445
- Phone: 717-483-2203
- Fax: 717-703-2445
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | SP017628 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | SP017628 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: