Individual
LORI LEEDS
Active
Individual
LORI LEEDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28128280
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081032
ANTHEM BS
IN
05
—
200086620
—
IN
01
—
28128280
INDIANA LICENSE
IN
Enumeration date
12/21/2006
Last updated
08/14/2013
Update your record
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