Provider Demographics
NPI:1427502269
Name:LEIDY E SANCHEZ, PLLC
Entity type:Organization
Organization Name:LEIDY E SANCHEZ, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIDY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:520-833-0315
Mailing Address - Street 1:4721 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5610
Mailing Address - Country:US
Mailing Address - Phone:520-833-0315
Mailing Address - Fax:520-844-8816
Practice Address - Street 1:4721 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5610
Practice Address - Country:US
Practice Address - Phone:520-833-0315
Practice Address - Fax:520-844-8816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN098563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN098563OtherSTATE LICENSE