Healthcare Provider Details

I. General information

NPI: 1891640462
Provider Name (Legal Business Name): LEANA D SHERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 MOUNTAIN RD
OLD FIELDS WV
26845-8614
US

IV. Provider business mailing address

358 MOUNTAIN RD
OLD FIELDS WV
26845-8614
US

V. Phone/Fax

Practice location:
  • Phone: 318-801-8000
  • Fax:
Mailing address:
  • Phone: 318-801-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number101302
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: