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General NPI Number Information
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NPI Number | 1750101895
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Entity Type | Individual
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Provider Name | LEAH BOEVE FNP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 675 W RANDALL ST
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City | COOPERSVILLE
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State | MI
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Zip | 49404-1305
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Country | US
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Telephone | 616-889-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 12151 LINDEN DR
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City | MARNE
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State | MI
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Zip | 49435-9684
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Country | US
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Telephone | 616-889-6011
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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 | 4704314023
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License Number State | MI
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