Provider Demographics
NPI:1831934272
Name:MINARD, LEAH MARIE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:MINARD
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:KIMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:330-325-3202
Mailing Address - Fax:833-606-1565
Practice Address - Street 1:4211 STATE ROUTE 44
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9733
Practice Address - Country:US
Practice Address - Phone:330-325-3202
Practice Address - Fax:833-606-1565
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036631363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0063625Medicaid