Provider Demographics
NPI:1003318114
Name:LOVELESS, LEAH D
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:D
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 LISLE LN
Mailing Address - Street 2:
Mailing Address - City:OREGONIA
Mailing Address - State:OH
Mailing Address - Zip Code:45054-9804
Mailing Address - Country:US
Mailing Address - Phone:513-600-3039
Mailing Address - Fax:513-600-3039
Practice Address - Street 1:149 LISLE LN
Practice Address - Street 2:
Practice Address - City:OREGONIA
Practice Address - State:OH
Practice Address - Zip Code:45054-9804
Practice Address - Country:US
Practice Address - Phone:513-600-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.375307163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse