Provider Demographics
NPI:1184409393
Name:SOUTHARD, LEAH (RN)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SOUTHARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WEWATTA ST STE 350
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5553
Mailing Address - Country:US
Mailing Address - Phone:866-808-6005
Mailing Address - Fax:
Practice Address - Street 1:2000 NW US HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66618-1445
Practice Address - Country:US
Practice Address - Phone:785-295-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS122778163WM0705X, 163WX0106X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health