Basic Information
| Provider Information | |||||||||
| NPI: | 1154748473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEECH | ||||||||
| FirstName: | LEILA | ||||||||
| MiddleName: | ASHLEA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 CHESTNUT RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265052807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042935323 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 930 CHESTNUT RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265052807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042935323 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2014 | ||||||||
| LastUpdateDate: | 12/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 0001219593 | VA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 0024171613 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | APRN91506-NP-C | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 91506 | WV | N | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | RXA2866 | 01 | WV | AUTHORIZATION TO PRESCRIBE | OTHER | 0017141530 | 01 | VA | AUTHORIZATION TO PRESCRIBE | OTHER |