Leyderman, Coralia Ilinca
Leyderman, Coralia Ilinca is an sole proprietor health care provider with primary practice located at 1601 Wentzville Pkwy Ste 117 , Wentzville MO 63385-3814. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Leyderman, Coralia Ilinca can be contacted via phone (636) 332-8455.Contact Information
Primary practice address
1601 Wentzville Pkwy Ste 117
Wentzville MO 63385-3814
Phone: (636) 332-8455
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2014025990 | Missouri |
Profile Details
| NPI number | 1124426812 |
|---|---|
| LBN Legal business name | Leyderman, Coralia Ilinca |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 11th, 2014 |
| Last updated | Nov 12th, 2020 - about 4 years 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 | 1124426812 | NPPES |
| Other | 1119413 | NCCPA | |
| Other | 2014025990 | NCCPA |
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