Individual
LEAH D PHILLIPS-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-4000
(502) 287-6906
Mailing address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-4000
(502) 287-6906
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4140P
KY
363LA2200X
Adult Health Nurse Practitioner
71001612A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200474340A
—
IN
Enumeration date
05/27/2005
Last updated
09/06/2012
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