Individual
CARRIE LYNN LEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1421 FISHBURN RD, HERSHEY, PA 17033-9795
(717) 533-2224
(717) 533-2164
Mailing address
1421 FISHBURN RD, HERSHEY, PA 17033-9795
(717) 533-2224
(717) 533-2164
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054383
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA054383
MEDICAL LICENSE
PA
Enumeration date
07/07/2010
Last updated
07/10/2012
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