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NPI Code Detail

MEDICARE: KIRSTEN D LEAVELL

MEDICARE: KIRSTEN D LEAVELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist31007090A.IN

General Provider Information

NPI Number : 1194357053
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTEN D LEAVELL
Provider Business Mailing Address
First Line : 55 WILLOW ST
Second Line :
City : NASHVILLE
State : IN
Zip : 47448-7013
Country : US
Telephone Number : 317-200-8846
Fax Number :
Provider Business Practice Location Address
First Line : 55 WILLOW ST
Second Line :
City : NASHVILLE
State : IN
Zip : 47448-7013
Country : US
Telephone Number : 812-988-6666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2020
Last Update Date : 02/09/2020

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Directions to “ KIRSTEN D LEAVELL ” Practice Location

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