Individual
NICOLE LOUISE LEATHERSICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
66 BIG RIDGE RD, SPENCERPORT, NY 14559-1221
(585) 775-7365
Mailing address
66 BIG RIDGE RD, SPENCERPORT, NY 14559-1221
(585) 775-7365
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
22645138
NY
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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