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General NPI Number Information
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NPI Number | 1699571877
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Entity Type | Individual
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Provider Name | MS. MORGAN LEIGH LEAVENTON
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Gender | Female
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 750 ROUND VALLEY DR STE 102
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City | PARK CITY
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State | UT
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Zip | 84060-7549
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Country | US
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Telephone | 435-655-0926
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Fax |
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Provider Business Mailing Address
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Address Line | 900 BITNER RD APT G13
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City | PARK CITY
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State | UT
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Zip | 84098-5483
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Country | US
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Telephone |
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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 | F01250858
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License Number State | UT
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