Individual
LEONDRE NIGHTENGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 HIGH ST, BRIDGEPORT, OH 43912-1305
(304) 280-1928
Mailing address
710 HIGH ST, BRIDGEPORT, OH 43912-1305
(304) 280-1928
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255523494
—
WV
05
—
1356607394
—
WV
05
—
1821206228
—
WV
Enumeration date
01/26/2022
Last updated
01/26/2022
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