Provider Demographics
NPI:1770822660
Name:ROSCOE, LEAH MARIE (RN, MS, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:ROSCOE
Suffix:
Gender:F
Credentials:RN, MS, FNP-BC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:KIRSCHLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:701 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2202
Mailing Address - Country:US
Mailing Address - Phone:608-263-5232
Mailing Address - Fax:
Practice Address - Street 1:701 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2202
Practice Address - Country:US
Practice Address - Phone:608-263-5232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6227363L00000X
CO0990510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23468OtherKAISER COMMERCIAL NUMBER
CO56436556Medicaid
CO281047YK5YMedicare PIN