| Doctor Name: | NICOLE E LEACH |
| NPI Number: | 1417187857 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 10679 |
| Business Practice Address: | 1607 State Rd 6 Vermilion, OH - 440899142 |
| Business Phone Number: | 4409678713 |
| Business Fax Number: | 4409671938 |
| Mailing Address: | Po Box 636643, CINCINNATI |
| State: | OH |
| Postal Code: | 452636643 |
| Phone Number: | 4409893801 |
| Fax Number: | 4409600264 |
| NPI Enumeration Date: | 07/20/2009 |
| NPI Last Update Date: | 01/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 10679 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |