Provider Demographics
NPI:1497136584
Name:RISTOW, LEAH A (CNP)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:A
Last Name:RISTOW
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 COLUMBIA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-7213
Mailing Address - Country:US
Mailing Address - Phone:440-250-5725
Mailing Address - Fax:440-250-5743
Practice Address - Street 1:850 COLUMBIA RD STE 101
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-7213
Practice Address - Country:US
Practice Address - Phone:440-250-5725
Practice Address - Fax:440-250-5743
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP17449363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health