Provider Demographics
NPI:1518580984
Name:CARROLL, LEIGH (RN MS NBC-HWC)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:RN MS NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 WILLIAM REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-3541
Mailing Address - Country:US
Mailing Address - Phone:401-644-3242
Mailing Address - Fax:
Practice Address - Street 1:350 WILLIAM REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:RI
Practice Address - Zip Code:02822-3541
Practice Address - Country:US
Practice Address - Phone:401-644-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIA-3196351174H00000X
RIRN56515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator