Provider Demographics
NPI:1841163995
Name:SULLENDER, LEONA MARIE
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:MARIE
Last Name:SULLENDER
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 1:1112 MILLSTON RD APT 96
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:OH
Mailing Address - Zip Code:45101-9565
Mailing Address - Country:US
Mailing Address - Phone:937-217-8775
Mailing Address - Fax:
Practice Address - Street 1:1112 MILLSTON RD APT 96
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:OH
Practice Address - Zip Code:45101-9565
Practice Address - Country:US
Practice Address - Phone:937-217-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty