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General NPI Number Information
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NPI Number | 1548513120
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Entity Type | Individual
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Provider Name | AMANDA CLAIRE LEGER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 1214 COOLIDGE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2621
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Country | US
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Telephone | 337-289-7529
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Fax | 337-289-7190
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Provider Business Mailing Address
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Address Line | 131 N 9TH ST
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City | EUNICE
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State | LA
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Zip | 70535-3103
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Country | US
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Telephone | 337-580-6242
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Fax | 770-874-5483
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.200562
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License Number State | LA
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