Healthcare Provider Details

I. General information

NPI: 1700614294
Provider Name (Legal Business Name): LEAH HOTTENSTEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH BEINLICH

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 HOSPITAL DRIVE
TOWANDA PA
18848-9702
US

IV. Provider business mailing address

91 HOSPITAL DRIVE
TOWANDA PA
18848-9702
US

V. Phone/Fax

Practice location:
  • Phone: 570-268-2372
  • Fax:
Mailing address:
  • Phone: 570-268-2372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN776914
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: