Healthcare Provider Details

I. General information

NPI: 1437433794
Provider Name (Legal Business Name): LEIGH SCHMERSAHL ROSE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEIGH ANNE SCHMERSAHL

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MAIN ST STE E
CARMEL IN
46032-1782
US

IV. Provider business mailing address

300 E MAIN ST STE E
CARMEL IN
46032-1782
US

V. Phone/Fax

Practice location:
  • Phone: 317-210-3722
  • Fax: 317-296-7211
Mailing address:
  • Phone:
  • Fax: 317-296-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71010288A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: