Provider Demographics
NPI:1174092282
Name:LEASURE, DANIELLE KAY
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KAY
Last Name:LEASURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:KAY
Other - Last Name:LEASURE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHLEBOTOMIST
Mailing Address - Street 1:2529 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1833
Mailing Address - Country:US
Mailing Address - Phone:740-297-8859
Mailing Address - Fax:
Practice Address - Street 1:2529 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1833
Practice Address - Country:US
Practice Address - Phone:740-297-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy