Individual
LEANN RUCKER NORTHCUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
8140 N MOPAC EXPY STE 3-210, AUSTIN, TX 78759-8859
(512) 343-2292
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000221514
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
AP144442
TX
Other
Enumeration date
04/18/2019
Last updated
01/28/2020
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