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General NPI Number Information
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NPI Number | 1194334359
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Entity Type | Individual
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Provider Name | NELSON LEACH APRN
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Gender | Male
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 38 BERWYN ST
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City | MILFORD
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State | CT
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Zip | 06461-4010
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Country | US
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Telephone | 203-571-3233
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Fax | 801-752-0632
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Provider Business Mailing Address
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Address Line | 793 POST RD E STE A204
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City | WESTPORT
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State | CT
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Zip | 06880-5243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 8964
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 8964
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 8964
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 8964
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License Number State | CT
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