Healthcare Provider Details

I. General information

NPI: 1942028006
Provider Name (Legal Business Name): LEIGH ANDERSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BOB BABBS DR
SPENCER IN
47460-6828
US

IV. Provider business mailing address

8003 CASTLEWAY DR
INDIANAPOLIS IN
46250-1946
US

V. Phone/Fax

Practice location:
  • Phone: 812-652-1700
  • Fax: 812-954-5023
Mailing address:
  • Phone: 317-576-1335
  • Fax: 317-343-6562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71015900A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: