Provider Demographics
NPI:1033532304
Name:DECURTIS, LEAH ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:ELIZABETH
Last Name:DECURTIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31501 N MARGINAL DR
Mailing Address - Street 2:APT C
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4402
Mailing Address - Country:US
Mailing Address - Phone:440-376-5550
Mailing Address - Fax:
Practice Address - Street 1:31501 N MARGINAL DR
Practice Address - Street 2:APT C
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-4402
Practice Address - Country:US
Practice Address - Phone:440-376-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137015-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse