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Individual

MRS. LESLIE LEA SHUGART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.N.P

Contact information

Practice address
960 WINDHAM CT STE 1, BOARDMAN, OH 44512-5087
(330) 726-3357
(330) 726-1465
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 626-6161
(419) 502-3511

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA10368NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2953719
OH
01
H237880
MEDICARE PTAN
OH
Enumeration date
04/30/2009
Last updated
01/10/2023
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