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General NPI Number Information
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NPI Number | 1043677248
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Entity Type | Individual
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Provider Name | LEANN M MARTIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1858 CHARTER LN STE 203
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City | LANCASTER
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State | PA
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Zip | 17601-6743
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Country | US
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Telephone | 717-779-4353
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Fax | 717-274-1659
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Provider Business Mailing Address
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Address Line | 100 NORTH QUEEN STREET SUITE 200
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City | LANCASTER
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State | PA
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Zip | 17603-3550
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Country | US
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Telephone | 717-779-4353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015734
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP015734
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License Number State | PA
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