Provider Demographics
NPI:1548519903
Name:SIMONCINI, LEAH A (CRNP)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:A
Last Name:SIMONCINI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:A
Other - Last Name:KOHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 TRINITY DR E STE 120
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-8522
Mailing Address - Country:US
Mailing Address - Phone:717-432-5430
Mailing Address - Fax:717-432-9296
Practice Address - Street 1:1 TRINITY DR E STE 120
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019
Practice Address - Country:US
Practice Address - Phone:717-432-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012235363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103052077Medicaid
PA265398Medicare PIN