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General NPI Number Information
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NPI Number | 1356652382
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Entity Type | Individual
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Provider Name | CARRIE JO LEIGHOW CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 2500 BELLEVUE MEDICAL CENTER DR ANESTHESIA DEPT
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City | BELLEVUE
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State | NE
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Zip | 68123-1591
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Country | US
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Telephone | 402-763-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 LAKE FOREST DR
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City | PAPILLION
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State | NE
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Zip | 68133-4739
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Country | US
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Telephone | 402-709-3446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26NJ00293800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 101126
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D105401
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License Number State | IA
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