Provider Demographics
NPI:1114527140
Name:CHOATE, LEAH SUZANNE (CNM)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:SUZANNE
Last Name:CHOATE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 CROSS COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:MINERAL
Mailing Address - State:VA
Mailing Address - Zip Code:23117-2519
Mailing Address - Country:US
Mailing Address - Phone:804-869-6824
Mailing Address - Fax:
Practice Address - Street 1:2048 CROSS COUNTY RD
Practice Address - Street 2:
Practice Address - City:MINERAL
Practice Address - State:VA
Practice Address - Zip Code:23117-2519
Practice Address - Country:US
Practice Address - Phone:804-869-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180424367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife