Individual
THERESA M. LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2301 S BROAD ST, 1ST FLOOR, METHODIST HOSPITAL, PHILADELPHIA, PA 19148-3542
(215) 952-9323
(215) 952-1246
Mailing address
2301 S BROAD ST, 1ST FLOOR, METHODIST HOSPITAL, PHILADELPHIA, PA 19148-3542
(215) 952-9323
(215) 952-1246
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN 251183L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019755890 024
—
PA
05
—
01975589-0001
—
PA
Enumeration date
12/15/2005
Last updated
10/30/2014
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