De Leon, Ivy Geralyn
De Leon, Ivy Geralyn is an individual health care provider with primary practice located at 106 Langtree Village Dr Ste 301 , Mooresville NC 28117-7594. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. De Leon, Ivy Geralyn can be contacted via phone (704) 978-8334.Contact Information
Primary practice address
106 Langtree Village Dr Ste 301
Mooresville NC 28117-7594
Phone: (704) 978-8334
Fax: (980) 399-2600
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 182897 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5004501 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 182897 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 5004501 | North Carolina |
Profile Details
| NPI number | 1871726679 |
|---|---|
| LBN Legal business name | De Leon, Ivy Geralyn |
| Credentials | PMHNP-BC, FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2009 |
| Last updated | May 20th, 2024 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871726679 | NPPES |
| North Carolina | Other | 2594567D | MEDICARE PTAN, INDIVIDUAL |
| North Carolina | MEDICAID | 7000658 | MEDICARE PTAN, INDIVIDUAL |
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