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Individual

HEATHER MARIA LEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2400 S 48TH ST, SPRINGDALE, AR 72762
(479) 750-2020
(479) 750-0076
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-8967

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R080384
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
223338
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297851758
AR
Enumeration date
05/14/2008
Last updated
09/27/2023
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