Healthcare Provider Details

I. General information

NPI: 1003457037
Provider Name (Legal Business Name): LEAH FESI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 FRANKFORD AVE
PHILADELPHIA PA
19124-2620
US

IV. Provider business mailing address

5000 FRANKFORD AVE
PHILADELPHIA PA
19124-2620
US

V. Phone/Fax

Practice location:
  • Phone: 215-831-2218
  • Fax:
Mailing address:
  • Phone: 215-831-2218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN593922
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP020888
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: