Provider Demographics
NPI:1700763869
Name:WANDA, LEANNE F
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:F
Last Name:WANDA
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 1:5320 ROCK CREEK CHURCH RD NE APT 116
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3401
Mailing Address - Country:US
Mailing Address - Phone:202-380-6886
Mailing Address - Fax:
Practice Address - Street 1:5320 ROCK CREEK CHURCH RD NE APT 116
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3401
Practice Address - Country:US
Practice Address - Phone:202-380-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide