Provider Demographics
NPI:1871763177
Name:LIN, LEAH MICHELLE (WHNP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MICHELLE
Last Name:LIN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
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Mailing Address - Street 1:701 SAN MATEO BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1434
Mailing Address - Country:US
Mailing Address - Phone:505-265-9511
Mailing Address - Fax:505-814-5743
Practice Address - Street 1:3220 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1932
Practice Address - Country:US
Practice Address - Phone:702-878-7776
Practice Address - Fax:707-878-7078
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2021-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT081476163W00000X
CA741506 OR 18750363LW0102X
390200000X
NV822113363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program