Individual
MRS. LEIGH LUCAS-CLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Mailing address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209008207
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
07/15/2010
Last updated
10/30/2013
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