Individual
MRS. MARISA RUTH LEIGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
451 HEALTH PKWY, SUITE A, PAW PAW, MI 49079-8242
(269) 657-2550
(269) 657-2285
Mailing address
451 HEALTH PKWY, SUITE A, PAW PAW, MI 49079-8242
(269) 657-2550
(269) 657-2285
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704209420
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437404746
—
MI
01
—
1801818752
BCBSM - BLH
MI
Enumeration date
07/24/2012
Last updated
11/27/2023
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