Basic Information
| Provider Information | |||||||||
| NPI: | 1063665875 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRESSLEY | ||||||||
| FirstName: | LEIGH | ||||||||
| MiddleName: | ADELL | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN/FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4530 E MUIRWOOD DR | ||||||||
| Address2: | STE 111 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850487693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809612365 | ||||||||
| FaxNumber: | 4809612382 | ||||||||
| Practice Location | |||||||||
| Address1: | 4530 E MUIRWOOD DR | ||||||||
| Address2: | STE 111 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850487693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809612365 | ||||||||
| FaxNumber: | 4802727321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2008 | ||||||||
| LastUpdateDate: | 03/24/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP3191 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.