Individual
LEILANI CALICA HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
Mailing address
110 29TH AVE N, NASHVILLE, TN 37203-1401
(615) 327-4304
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
600584
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
50592
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002932402
—
TX
01
—
050592
RECERTIFICATION
TX
05
—
3636554
—
TN
01
—
4133317
BCBS OF TN
TN
01
—
430068752
RAILROAD MEDICARE
TX
05
—
74012055
—
KY
01
—
82960U
BLUE CROSS BLUE SHIELD
TX
05
—
9938554
—
AL
Enumeration date
10/26/2005
Last updated
09/04/2013
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