Healthcare Provider Details

I. General information

NPI: 1003620261
Provider Name (Legal Business Name): LEAH SUCHORA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MARKET ST
BOARDMAN OH
44512-6725
US

IV. Provider business mailing address

1260 CEDARWOOD DR
MINERAL RIDGE OH
44440-9412
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-4350
  • Fax:
Mailing address:
  • Phone: 330-774-5042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM09962
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: