| NPI | 1639473713 |
|---|---|
| Former Name | NIKKI ELIZABETH LEEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016243) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 68690) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2022-04-21 |