Provider Demographics
NPI:1396252979
Name:RICHCREEK, LEANNE MICHELE (BSN)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:MICHELE
Last Name:RICHCREEK
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9747
Mailing Address - Country:US
Mailing Address - Phone:717-825-9879
Mailing Address - Fax:
Practice Address - Street 1:1930 VALLEY RD
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9747
Practice Address - Country:US
Practice Address - Phone:717-825-9879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN682838163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse