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Individual

ELLEN R LEICHERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
10000 BAY PINES BOULEVARD, BAY PINES, FL 33744-8200
(727) 398-6661
Mailing address
10006 BENTLEY WAY, TAMPA, FL 33626-5141
(727) 967-4838

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11034247
FL

Other

Enumeration date
10/11/2024
Last updated
10/19/2024
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