Provider Demographics
NPI:1841154457
Name:SKIPPER, LEAH (MS,RD,LD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SKIPPER
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-6805
Mailing Address - Country:US
Mailing Address - Phone:334-437-1813
Mailing Address - Fax:888-866-9950
Practice Address - Street 1:1803A E THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36421-2403
Practice Address - Country:US
Practice Address - Phone:409-767-8100
Practice Address - Fax:888-977-1202
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-10
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1597133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered