Provider Demographics
NPI:1083187934
Name:SAPP, CARLEIGH JEAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARLEIGH
Middle Name:JEAN
Last Name:SAPP
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CARLEIGH
Other - Middle Name:JEAN
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:209 N MAYSVILLE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1179
Mailing Address - Country:US
Mailing Address - Phone:859-404-7686
Mailing Address - Fax:859-498-8160
Practice Address - Street 1:209 N MAYSVILLE ST STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1179
Practice Address - Country:US
Practice Address - Phone:859-404-7686
Practice Address - Fax:859-498-8160
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101798363LF0000X
KY3012850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3012850OtherAPRN LICENSE
WV101798OtherNURSING LICENSE
KY7100577940Medicaid