Provider Demographics
NPI:1033648670
Name:LEPPAN, NATASHA NICOLE (CRNA)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:NICOLE
Last Name:LEPPAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:GAMBINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:425 LEWIS HARGETT CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3590
Mailing Address - Country:US
Mailing Address - Phone:859-268-1030
Mailing Address - Fax:859-269-4120
Practice Address - Street 1:425 LEWIS HARGETT CIR STE 405
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3590
Practice Address - Country:US
Practice Address - Phone:185-926-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9362776163W00000X
FL514489367500000X
KY3014618367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse