Individual
HEATHER LEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 KENTUCKY AVE, SUITE 103, PADUCAH, KY 42003-3817
(270) 415-4860
(270) 415-4862
Mailing address
PO BOX 7309, PADUCAH, KY 42002-7309
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006881
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100239080
—
KY
Enumeration date
04/15/2011
Last updated
12/08/2020
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