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NPI Code Detail

MEDICARE: MRS. AMBER VALERIE LEONHARDT PMHNP-BC

MEDICARE: MRS. AMBER VALERIE LEONHARDT PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRNP240107AZ

General Provider Information

NPI Number : 1073142386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMBER VALERIE LEONHARDT PMHNP-BC
Provider Business Mailing Address
First Line : 3832 E PUEBLO AVE
Second Line :
City : MESA
State : AZ
Zip : 85206-1838
Country : US
Telephone Number : 480-310-2924
Fax Number :
Provider Business Practice Location Address
First Line : 3271 E QUEEN CREEK RD STE 101
Second Line :
City : GILBERT
State : AZ
Zip : 85297-8511
Country : US
Telephone Number : 480-550-3193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2020
Last Update Date : 04/07/2020

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