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General NPI Number Information
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NPI Number | 1679391395
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Entity Type | Individual
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Provider Name | SIERRA LEGEER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON ROAD SUITE 2E99
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-733-5982
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Fax | 302-733-6081
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Provider Business Mailing Address
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Address Line | 1221 S BROAD ST APT 302
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City | PHILADELPHIA
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State | PA
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Zip | 19147-4443
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Country | US
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Telephone | 904-625-0443
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0012178
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License Number State | DE
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