MEDICARE: NADINE LEISHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1568316164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE LEISHMAN

Provider Business Mailing Address
First Line	:	PO BOX 125
Second Line	:
City	:	PAW PAW
State	:	WV
Zip	:	25434-0125
Country	:	US
Telephone Number	:	304-809-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 RIVER BEND DR
Second Line	:
City	:	PAW PAW
State	:	WV
Zip	:	25434-8754
Country	:	US
Telephone Number	:	304-809-2656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “ NADINE LEISHMAN ” Practice Location

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