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NPI Code Detail

MEDICARE: KARLEEN M LEASURE CRNP

MEDICARE: KARLEEN M LEASURE CRNP
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
1363LF0000XFamily Nurse PractitionerRO91026MD

General Provider Information

NPI Number : 1073507802
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLEEN M LEASURE CRNP
Provider Business Mailing Address
First Line : 441 CLOVERDALE CIR
Second Line :
City : SEVERNA PARK
State : MD
Zip : 21146-2306
Country : US
Telephone Number : 410-987-8919
Fax Number :
Provider Business Practice Location Address
First Line : 2601 RIVA RD
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7304
Country : US
Telephone Number : 410-571-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 01/30/2009

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