Provider Demographics
NPI:1104460468
Name:CLAERHOUT, LEIGHA
Entity type:Individual
Prefix:MRS
First Name:LEIGHA
Middle Name:
Last Name:CLAERHOUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 PARKLANE DR
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:MI
Mailing Address - Zip Code:48001-4225
Mailing Address - Country:US
Mailing Address - Phone:810-335-2897
Mailing Address - Fax:
Practice Address - Street 1:135 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-1607
Practice Address - Country:US
Practice Address - Phone:810-765-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704354781163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse