Healthcare Provider Details

I. General information

NPI: 1184136681
Provider Name (Legal Business Name): LEIGH HAHN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13454 S ORANGE BLOSSOM TRL
ORLANDO FL
32837-6601
US

IV. Provider business mailing address

13454 S ORANGE BLOSSOM TRL
ORLANDO FL
32837-6601
US

V. Phone/Fax

Practice location:
  • Phone: 407-240-3191
  • Fax:
Mailing address:
  • Phone: 407-240-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9396992
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9396992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: