Provider Demographics
NPI:1336662436
Name:PAULL, LEAH MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:PAULL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:FREDERIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:3250 W MARKET ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3318
Mailing Address - Country:US
Mailing Address - Phone:330-606-9561
Mailing Address - Fax:
Practice Address - Street 1:3250 W MARKET ST STE 2
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3318
Practice Address - Country:US
Practice Address - Phone:330-606-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.150496.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse