Individual
MISTY BASHAM-LEEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1906 BELLEVIEW AVE SE, CARILION RMH - DEPARTMENT OF EMERGENCY MEDICINE, ROANOKE, VA 24014-1838
(540) 266-6331
(540) 981-9550
Mailing address
1906 BELLEVIEW AVENUE, CARILION RMH - DEPARTMENT OF EMERGENCY MEDICINE, ROANOKE, VA 24014
(540) 266-6331
(540) 981-9550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003761
VA
Other
Enumeration date
02/06/2012
Last updated
09/29/2021
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