Individual
MIKAYLA LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
Mailing address
408 S ROBERTS ST, HUMBOLDT, SD 57035-2059
(210) 863-9569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R059910
SD
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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