Provider Demographics
NPI:1225408230
Name:LEAVENGOOD, JESSICA DANIELLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DANIELLE
Last Name:LEAVENGOOD
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:1050 BOWER HILL RD STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1866
Practice Address - Country:US
Practice Address - Phone:412-942-7262
Practice Address - Fax:412-942-7397
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2021-04-19
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Provider Licenses
StateLicense IDTaxonomies
PAMA05917363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical