Provider Demographics
NPI:1538037429
Name:MULLET HERSHBERGER, LEAH (RN, BSN)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MULLET HERSHBERGER
Suffix:
Gender:X
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2196 E WILLIAMS FIELD RD STE 116
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0755
Mailing Address - Country:US
Mailing Address - Phone:602-335-9305
Mailing Address - Fax:
Practice Address - Street 1:2196 E WILLIAMS FIELD RD STE 116
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0755
Practice Address - Country:US
Practice Address - Phone:602-335-9305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ150752163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse