LEADING EDGE HEALTHCARE PLLC NPI 1659017499

NPI Information

NPI: 1659017499
Provider Name: LEADING EDGE HEALTHCARE, PLLC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
724 N MONTEZUMA ST STE A
PRESCOTT, AZ
ZIP 86301
Phone: (928) 925-2871
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LEADING EDGE HEALTHCARE, PLLC is a medical physician assistant in Prescott, AZ. LEADING EDGE HEALTHCARE, PLLC NPI is 1659017499. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

724 N MONTEZUMA ST STE A
PRESCOTT, AZ
ZIP 86301-066
Phone: (928) 925-2871

The provider's authorized official is Jacob Kirkeeng .
The authorized official title is Owner Member and has the following contact phone number (928) 925-2871.

The enumeration date for this NPI number is 5/5/2022 and was last updated on 5/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	363AM0700X	Physician Assistant	Medical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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