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General NPI Number Information
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NPI Number | 1164227666
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Entity Type | Individual
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Provider Name | ANNETTE LEON PHD, MS, FACMG
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8724 HUMIE OLIVE RD
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City | APEX
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State | NC
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Zip | 27502-9672
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Country | US
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Telephone | 417-259-6099
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Fax |
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Provider Business Mailing Address
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Address Line | 8724 HUMIE OLIVE RD
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City | APEX
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State | NC
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Zip | 27502-9672
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Country | US
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Telephone | 417-259-6099
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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 | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number | 2015141
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number | 2011124
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License Number State | MD
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