Individual
DARLA C LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6901
(502) 852-6056
Mailing address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6901
(502) 852-6056
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1097124
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3004808
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74012667
—
KY
Enumeration date
10/10/2006
Last updated
09/17/2012
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