Healthcare Provider Details

I. General information

NPI: 1053187120
Provider Name (Legal Business Name): LEAH CORNETT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH CRUM APRN

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 SCHOOL DR
CARLISLE KY
40311-1052
US

IV. Provider business mailing address

236 W MAIN ST
MOUNT STERLING KY
40353-1348
US

V. Phone/Fax

Practice location:
  • Phone: 859-473-5220
  • Fax: 859-498-8160
Mailing address:
  • Phone: 859-404-7686
  • Fax: 859-498-8160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4010037
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: