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NPI Code Detail

MEDICARE: MRS. LEIGH LUCAS-CLAY CRNA

MEDICARE: MRS. LEIGH LUCAS-CLAY CRNA
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
1367500000XCertified Registered Nurse Anesthetist11018660FL
2367500000XCertified Registered Nurse Anesthetist209008207IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790098119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEIGH LUCAS-CLAY CRNA
Provider Business Mailing Address
First Line : 8600 N STATE ROUTE 91
Second Line : SUITE 250
City : PEORIA
State : IL
Zip : 61615-9541
Country : US
Telephone Number : 309-692-5393
Fax Number : 309-692-2538
Provider Business Practice Location Address
First Line : 8600 N STATE ROUTE 91
Second Line : SUITE 250
City : PEORIA
State : IL
Zip : 61615-9541
Country : US
Telephone Number : 309-692-5393
Fax Number : 309-692-2538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 06/18/2026

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Directions to “ MRS. LEIGH LUCAS-CLAY CRNA” Practice Location

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