Basic Information
| Provider Information | |||||||||
| NPI: | 1871803569 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAWBY | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | MIRIAM | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3724 MIDDLEBURG LN | ||||||||
| Address2: | APT 105 | ||||||||
| City: | ROCKLEDGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329554565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217499316 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2900 VETERANS WAY | ||||||||
| Address2: | |||||||||
| City: | VIERA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329408007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216373788 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2010 | ||||||||
| LastUpdateDate: | 10/14/2010 | ||||||||
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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 | 9228004 | FL | Y | Nursing Service Providers | Registered Nurse | 163WE0003X | 9228004 | FL | N | Nursing Service Providers | Registered Nurse | Emergency | 163WP2201X | 9228004 | FL | N | Nursing Service Providers | Registered Nurse | Ambulatory Care |
No ID Information.