Provider Demographics
NPI:1568358026
Name:KAGUCHU, LEAH MURUGI (FNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MURUGI
Last Name:KAGUCHU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MURUGI
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:3810 DUDLEY DR
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-6272
Mailing Address - Country:US
Mailing Address - Phone:574-323-0206
Mailing Address - Fax:
Practice Address - Street 1:3810 DUDLEY DR
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-6272
Practice Address - Country:US
Practice Address - Phone:574-323-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28228785C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily