Provider Demographics
NPI:1417203431
Name:COWLES, LEAH R (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:R
Last Name:COWLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 NANTUCKET DR E
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4843
Mailing Address - Country:US
Mailing Address - Phone:716-901-3133
Mailing Address - Fax:716-601-7167
Practice Address - Street 1:132 NANTUCKET DR E
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4843
Practice Address - Country:US
Practice Address - Phone:716-901-3133
Practice Address - Fax:716-601-7167
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303511-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse