Healthcare Provider Details

I. General information

NPI: 1255615266
Provider Name (Legal Business Name): LEESA SCHWARZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-0284
US

IV. Provider business mailing address

800 ROSE ST
LEXINGTON KY
40536-0284
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0295
  • Fax: 859-323-1256
Mailing address:
  • Phone: 859-323-0295
  • Fax: 859-275-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3007089
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3007089
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: