Miss AMANDA M LEISURE CPNP-AC/PC
Individual Provider (NPI-1)
Active
Nurse Practitioner, Pediatrics
Provider Information
- NPI Number
1154872653- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CPNP-AC/PC
- Status
- Active
Contact & Location
- Address
- 11141 PARKVIEW PLAZA DR STE 210, FORT WAYNE, IN, 468451714
- Phone
- (260) 266-5400
- Fax
- (260) 266-5409
Specialties & Taxonomies
Nurse Practitioner, Pediatrics
Primary License: IN #71006767
All Addresses
MAILING
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN, 468451701