Healthcare Provider Details

I. General information

NPI: 1831668805
Provider Name (Legal Business Name): KRISTI S LEONHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTI L SWEIGART

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BERNVILLE RD
READING PA
19605-9453
US

IV. Provider business mailing address

107 W FRANKLIN ST
EPHRATA PA
17522-1932
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2159
  • Fax:
Mailing address:
  • Phone: 717-940-7535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN620408
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN620408
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: