Provencher, Leigh Mae

Provencher, Leigh Mae is an individual health care provider with primary practice located at 1818 N Meade St , Appleton WI 54911-3454. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Provencher, Leigh Mae can be contacted via phone (920) 735-7645.

Contact Information

Primary practice address
1818 N Meade St Appleton WI 54911-3454
Phone: (920) 735-7645
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X RS2020-0448 New Mexico
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 83019 Wisconsin

Profile Details

NPI number 1063949741
LBN Legal business name Provencher, Leigh Mae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2017
Last updated May 15th, 2024 - about last year

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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