Individual
LEAH K TYRRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3836
(856) 755-0098
Mailing address
PO BOX 8505, CHERRY HILL, NJ 08002-0505
(856) 755-1616
(856) 755-0098
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00237200
NJ
367500000X
Certified Registered Nurse Anesthetist
26NR12279100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220041639
TAX ID
NJ
Enumeration date
11/17/2008
Last updated
06/30/2021
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