Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3009762 | KY |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3009762 | KY |
NPI | 1134599764 |
---|---|
Provider Name | Mrs. Brionna Virginia Leahy |
First Address | Lexington, KY 40508-1683 |
Second Address | Lexington, KY 40536-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2015 |
Last Update Date | 10/06/2020 |