Provider Demographics
NPI:1730966318
Name:LEIDHEISER, BRITTNEY (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:LEIDHEISER
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 W 5TH AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4899
Mailing Address - Country:US
Mailing Address - Phone:614-224-6420
Mailing Address - Fax:614-224-6423
Practice Address - Street 1:2323 W 5TH AVE STE 225
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-4899
Practice Address - Country:US
Practice Address - Phone:614-224-6420
Practice Address - Fax:614-224-6423
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008828RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant