Individual
NICOLE E LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1607 STATE RD, 6, VERMILION, OH 44089-9142
(440) 967-8713
(440) 967-1938
Mailing address
PO BOX 636643, CINCINNATI, OH 45263-6643
(440) 989-3801
(440) 960-0264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN.CNP.10679
OH
363LP0200X
Pediatric Nurse Practitioner
Primary
10679
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236248
—
OH
05
—
3025372
—
OH
Enumeration date
07/20/2009
Last updated
08/04/2017
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