Bernier, Latisha Rae Leonard

Bernier, Latisha Rae Leonard is an individual health care provider with primary practice located at 1919 E Thomas Rd East Building, Phoenix AZ 85016-7710. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Bernier, Latisha Rae Leonard can be contacted via phone (602) 546-1900.

Contact Information

Primary practice address
1919 E Thomas Rd East Building Phoenix AZ 85016-7710
Phone: (602) 546-1900
Fax: (602) 546-1918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 0405 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 4535 Arizona

Profile Details

NPI number 1780649210
LBN Legal business name Bernier, Latisha Rae Leonard
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jun 21st, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780649210 NPPES
Arizona MEDICAID 470355

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