Provider Demographics
NPI:1669250874
Name:LEAH GOOD LLC
Entity type:Organization
Organization Name:LEAH GOOD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:952-592-0116
Mailing Address - Street 1:5775 WAYZATA BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1233
Mailing Address - Country:US
Mailing Address - Phone:952-592-0116
Mailing Address - Fax:952-592-0118
Practice Address - Street 1:925 E SUPERIOR ST STE 106
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2253
Practice Address - Country:US
Practice Address - Phone:320-348-1200
Practice Address - Fax:320-217-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty