NPI Code Details Logo

NPI 1568316164

NPI 1568316164 : NADINE LEISHMAN : PAW PAW, WV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1568316164
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    NADINE LEISHMAN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/23/2026
-----------------------------------------------------
    Last Update Date     |    02/23/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    641 RIVER BEND DR 
-----------------------------------------------------
    City                 |    PAW PAW
-----------------------------------------------------
    State                |    WV
-----------------------------------------------------
    Zip                  |    25434-8754
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    304-809-2656
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 125 
-----------------------------------------------------
    City                 |    PAW PAW
-----------------------------------------------------
    State                |    WV
-----------------------------------------------------
    Zip                  |    25434-0125
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    304-809-2656
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    252Y00000X
-----------------------------------------------------
    Taxonomy Name        |    Early Intervention Provider Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.