Provider Demographics
NPI:1881066124
Name:NANCE, LEIGHNIA TYRESE (RN)
Entity type:Individual
Prefix:
First Name:LEIGHNIA
Middle Name:TYRESE
Last Name:NANCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 EASTERN BYP
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2512
Mailing Address - Country:US
Mailing Address - Phone:859-626-0072
Mailing Address - Fax:859-626-9684
Practice Address - Street 1:3099 HELMSDALE PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2213
Practice Address - Country:US
Practice Address - Phone:859-258-6401
Practice Address - Fax:859-258-6438
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1118961163W00000X
KY3009993363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1118961OtherRN NUMBER
KY1118961OtherRN NUMBER