Provider Demographics
NPI:1194945527
Name:WELCH, LEIGH ANNE (LPN)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:WELCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 COUNTY ROAD 1 LOT 19
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-8107
Mailing Address - Country:US
Mailing Address - Phone:304-690-0966
Mailing Address - Fax:
Practice Address - Street 1:2301 S 7TH ST STE 3
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2542
Practice Address - Country:US
Practice Address - Phone:740-533-9850
Practice Address - Fax:740-533-9852
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN106330.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMMISODJFSMedicaid