Provider Demographics
NPI:1295467371
Name:LINK, LEAH J
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:J
Last Name:LINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:J
Other - Last Name:STUKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220-0752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 BADGER GLEN RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-4020
Practice Address - Country:US
Practice Address - Phone:603-998-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01722422164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse