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Individual

MS. BONNIE MARIE LEAVERTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
109 ELM ST, GENEVA, OH 44041-1003
(440) 415-3124
Mailing address
109 ELM ST, GENEVA, OH 44041-1003
(440) 415-3124

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN130853
OH

Other

Enumeration date
07/16/2021
Last updated
07/16/2021
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