Provider Demographics
NPI:1003092834
Name:YOUNGBLOOD - WEST, LEIGH ANN (MSN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANN
Last Name:YOUNGBLOOD - WEST
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:MRS
Other - First Name:LEIGH
Other - Middle Name:ANN
Other - Last Name:YOUNGBLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, NP-C
Mailing Address - Street 1:2122 MANCHESTER EXPY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6878
Mailing Address - Country:US
Mailing Address - Phone:706-596-4000
Mailing Address - Fax:
Practice Address - Street 1:2122 MANCHESTER EXPY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6878
Practice Address - Country:US
Practice Address - Phone:706-596-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN150142163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily