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General NPI Number Information
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NPI Number | 1578073185
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Entity Type | Individual
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Provider Name | MEGAN MARIE LEADBETTER NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 4883 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-3635
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Country | US
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Telephone | 330-479-9193
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Fax |
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Provider Business Mailing Address
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Address Line | 1238 PRINCEHORN AVE NW
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City | NORTH LAWRENCE
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State | OH
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Zip | 44666-9703
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Country | US
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Telephone | 330-936-0953
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LE-00020904
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License Number State | OH
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