Individual
KELLY MARIE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201
(701) 780-2300
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R156241-1
MN
363LF0000X
Family Nurse Practitioner
Primary
R29405
ND
Other
Enumeration date
09/16/2009
Last updated
02/28/2019
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