Provider Demographics
NPI:1093948747
Name:PALMER, LEAH MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MICHELLE
Last Name:PALMER
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 1:1132 APPLEGROVE ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1677
Mailing Address - Country:US
Mailing Address - Phone:330-956-0070
Mailing Address - Fax:
Practice Address - Street 1:1132 APPLEGROVE ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1677
Practice Address - Country:US
Practice Address - Phone:330-956-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN134133-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse