Healthcare Provider Details

I. General information

NPI: 1598166571
Provider Name (Legal Business Name): LEIGH ALLISON O'BRYAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEIGH ALLISON LUDWIG CRNA

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 03/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AKRON GENERAL AVE
AKRON OH
44307-2432
US

IV. Provider business mailing address

4200 WHITMAN AVE
CLEVELAND OH
44113
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-6000
  • Fax: 330-344-1714
Mailing address:
  • Phone: 304-532-7022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number12.006433
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.16488
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: