Provider Demographics
NPI:1770289597
Name:LEONARD, KELSEY JANE (BSN, RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:JANE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-5813
Mailing Address - Country:US
Mailing Address - Phone:937-974-1764
Mailing Address - Fax:
Practice Address - Street 1:5861 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-5813
Practice Address - Country:US
Practice Address - Phone:937-974-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.363848163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant