| NPI | 1316433535 |
|---|---|
| Former Name | BRENNA MARIE LEACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007998A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28209875A) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2021-01-05 |