Healthcare Provider Details

I. General information

NPI: 1093627143
Provider Name (Legal Business Name): LEAH KAYE LEVI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 GLENN LN
GREENBRIER AR
72058-9248
US

IV. Provider business mailing address

3500 BRUNDLE CT
SHERWOOD AR
72120-4380
US

V. Phone/Fax

Practice location:
  • Phone: 501-679-2111
  • Fax: 501-679-1016
Mailing address:
  • Phone: 501-679-2111
  • Fax: 501-679-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL031463
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: