Provider Demographics
NPI:1457174542
Name:LEISURE, ELIZABETH SUZANNE
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SUZANNE
Last Name:LEISURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1106
Mailing Address - Country:US
Mailing Address - Phone:740-606-3702
Mailing Address - Fax:
Practice Address - Street 1:228 N BEND CT NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-9479
Practice Address - Country:US
Practice Address - Phone:740-606-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health