Individual
LEAH C. CLEMENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
26629 RICHARD DR, WIND LAKE, WI 53185-1345
(262) 895-2058
Mailing address
26629 RICHARD DR, WIND LAKE, WI 53185-1345
(262) 895-2058
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
163WH0200X
Home Health Registered Nurse
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35011900
—
WI
Enumeration date
02/19/2007
Last updated
10/02/2007
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