MEDICARE: LEEAH APRYL THURSTON

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
1	363LF0000X	Family Nurse Practitioner	APRN11032704	FL

General Provider Information

NPI Number	:	1285511261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEEAH APRYL THURSTON

Provider Business Mailing Address
First Line	:	6260 WESTOVER RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5471
Country	:	US
Telephone Number	:	786-486-6613
Fax Number	:

Provider Business Practice Location Address
First Line	:	6260 WESTOVER RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5471
Country	:	US
Telephone Number	:	786-486-6613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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