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NPI Code Detail

MEDICARE: ANDREW LEAVENS BSN

MEDICARE: ANDREW LEAVENS BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0200XCritical Care Medicine Registered Nurse325905NC

General Provider Information

NPI Number : 1518811983
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW LEAVENS BSN
Provider Business Mailing Address
First Line : 10628 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 704-667-1000
Fax Number :
Provider Business Practice Location Address
First Line : 10628 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 704-667-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/23/2026

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