Individual
CONSTANCE LEE BALLEM LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
850 N 11TH ST, PHILADELPHIA, PA 19123-1957
(215) 769-1100
Mailing address
135 E LEHIGH AVE, PHILADELPHIA, PA 19125-1011
(215) 425-5400
(215) 425-0918
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP007552
PA
Other
Enumeration date
07/21/2006
Last updated
04/22/2024
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