Provider Demographics
NPI:1366223356
Name:LEACHMAN, TAMEIKA
Entity type:Individual
Prefix:
First Name:TAMEIKA
Middle Name:
Last Name:LEACHMAN
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 1:25400 ROCKSIDE RD APT 326A
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1913
Mailing Address - Country:US
Mailing Address - Phone:216-338-1129
Mailing Address - Fax:
Practice Address - Street 1:25400 ROCKSIDE RD APT 326A
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1913
Practice Address - Country:US
Practice Address - Phone:216-338-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH513374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse