Individual
TARA LEISENRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
567 MONTOUR RD, PAXINOS, PA 17860-7106
(570) 898-2649
Mailing address
398 AIRPORT RD, SHAMOKIN, PA 17872-7504
(570) 259-9743
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN618109
PA
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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