Provider Demographics
NPI:1497934863
Name:STIPE, LEAH MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:STIPE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:STIPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3957 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-2284
Mailing Address - Country:US
Mailing Address - Phone:440-967-8942
Mailing Address - Fax:
Practice Address - Street 1:3957 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-2284
Practice Address - Country:US
Practice Address - Phone:440-967-8942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN103413164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse