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General NPI Number Information
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NPI Number | 1063729671
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Entity Type | Individual
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Provider Name | LAURA LYNN LEAL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 3200 S ALMA SCHOOL RD STE #204
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City | CHANDLER
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State | AZ
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Zip | 85248-3757
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Country | US
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Telephone | 480-814-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 2458 E BRIDGEPORT PKWY
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City | GILBERT
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State | AZ
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Zip | 85295-2350
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Country | US
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Telephone | 408-309-4288
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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 | AP3763
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License Number State | AZ
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