Provider Demographics
NPI:1821050733
Name:LEAMY, VICKI H (RNC, MSN, NNP)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:H
Last Name:LEAMY
Suffix:
Gender:F
Credentials:RNC, MSN, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:101 ELM AVE SE
Mailing Address - Street 2:PEDIATRIX MEDICAL GROUP
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24013-2222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 ELM AVE SE
Practice Address - Street 2:PEDIATRIX, CARILION ROANOKE COMMUNITY HOSPITAL
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2222
Practice Address - Country:US
Practice Address - Phone:540-985-8051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024153127363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal