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General NPI Number Information
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NPI Number | 1598573131
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Entity Type | Individual
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Provider Name | LEAH KAYTLYN GIRDNER RN, BSN,CCRN
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 602 INDIANA AVE
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City | LUBBOCK
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State | TX
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Zip | 79415-3364
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Country | US
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Telephone | 806-775-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 415 RAIDER BLVD
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City | WOLFFORTH
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State | TX
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Zip | 79382-5309
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Country | US
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Telephone | 806-777-4504
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 1036513
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License Number State | TX
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