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Individual
RUBY RENEE LEACH
Active
Individual
RUBY RENEE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003269
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3600818
MEDICAID LAB GROUP#
KY
01
—
4000501
MEDICARE LAB GROUP#
KY
01
—
500027063
RR MEDICARE PIN#
GA
05
—
78004264
—
KY
01
—
CB5773
RR MEDICARE GROUP#
GA
Enumeration date
10/03/2006
Last updated
12/08/2020
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