IndividualActive
Amanda Leisure, CPNP-AC/PC
NPI 1154872653 · Pediatric Nurse Practitioner · Fort Wayne, IN
Provider details
- NPI number
- 1154872653
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-AC/PC
- Sex
- Female
- Sole proprietor
- No
- License
- 71006767 (IN)
Practice location
11141 Parkview Plaza Dr Ste 210
Fort Wayne, IN 46845-1714
Phone: (260) 266-5400
Fax: (260) 266-5409
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Registry dates
- Enumerated
- 2016-10-19
- Last updated
- 2022-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.