Provider Demographics
NPI:1679274450
Name:LEACHMAN, TALESHA D (APRN)
Entity type:Individual
Prefix:
First Name:TALESHA
Middle Name:D
Last Name:LEACHMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11711 TAYLOR RAE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-6500
Mailing Address - Country:US
Mailing Address - Phone:502-472-4353
Mailing Address - Fax:
Practice Address - Street 1:734 W MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3622
Practice Address - Country:US
Practice Address - Phone:502-653-5800
Practice Address - Fax:447-200-2726
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3019067363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health