Healthcare Provider Details

I. General information

NPI: 1508045832
Provider Name (Legal Business Name): LEOLA MICHELLE MAY RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 SUMNER ST
AKRON OH
44311-2168
US

IV. Provider business mailing address

814 SUMNER ST
AKRON OH
44311-2168
US

V. Phone/Fax

Practice location:
  • Phone: 330-329-7622
  • Fax:
Mailing address:
  • Phone: 330-329-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number318993
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: