Individual
CAROLYN ELIZABETH LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6624
(651) 220-6064
Mailing address
5901 LINCOLN DR, CBC-2-REV/PE, EDINA, MN 55436-1611
(651) 220-6624
(651) 220-6064
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R156707-6
MN
Other
Enumeration date
11/05/2009
Last updated
05/01/2018
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