Provider Demographics
NPI:1124390315
Name:KISH, LEAH (RN)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:
Last Name:KISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E 220TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1107
Mailing Address - Country:US
Mailing Address - Phone:216-269-3377
Mailing Address - Fax:
Practice Address - Street 1:440 ORCHARDVIEW RD
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-5841
Practice Address - Country:US
Practice Address - Phone:216-544-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH353919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse