Provider Demographics
NPI:1245584671
Name:HOLLINS, LEAH ELAINE
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:ELAINE
Last Name:HOLLINS
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 1:1565 LEE TERRACE SR
Mailing Address - Street 2:E8
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092
Mailing Address - Country:US
Mailing Address - Phone:216-906-6586
Mailing Address - Fax:
Practice Address - Street 1:1565 LEE TERRACE DR
Practice Address - Street 2:E8
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092
Practice Address - Country:US
Practice Address - Phone:216-906-6586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152539164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse