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General NPI Number Information
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NPI Number | 1801480686
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Entity Type | Individual
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Provider Name | LEIGHANNE WAY
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Gender | Female
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 111 2ND AVE NE STE 700
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3441
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Country | US
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Telephone | 800-975-4819
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Fax |
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Provider Business Mailing Address
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Address Line | 10140 CENTURION PKWY N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0532
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Country | US
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Telephone | 904-697-4100
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 247.000143
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC64
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License Number State | FL
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