Individual
LAWRENCE CLARK LEONARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
727 HOSPITAL DR, SHELBYVILLE, KY 40065-1660
(502) 647-4085
(502) 647-4098
Mailing address
100 E LIBERTY ST, 8TH FLOOR, LOUISVILLE, KY 40202-1434
(502) 647-4085
(502) 647-4098
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0024052435
VA
163W00000X
Registered Nurse
1044538
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3000345
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200902420A
—
IN
05
—
7403451300
—
KY
Enumeration date
10/27/2006
Last updated
04/17/2018
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