Healthcare Provider Details

I. General information

NPI: 1790413201
Provider Name (Legal Business Name): LEIGH ANN STEPHENSON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LOCUST AVE EXT STE 2
MT MORRIS PA
15349-1355
US

IV. Provider business mailing address

120 LOCUST AVE EXT STE 2
MT MORRIS PA
15349-1355
US

V. Phone/Fax

Practice location:
  • Phone: 724-324-5555
  • Fax: 724-324-5557
Mailing address:
  • Phone: 724-324-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP044702L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: