Provider Demographics
NPI:1518589563
Name:TOOLEY, LEANNE SIMS (APRN)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:SIMS
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 OLD NASHVILLE LOOP 3 RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:KY
Mailing Address - Zip Code:42170-9603
Mailing Address - Country:US
Mailing Address - Phone:270-779-9301
Mailing Address - Fax:
Practice Address - Street 1:1320 ANDREA ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3334
Practice Address - Country:US
Practice Address - Phone:270-746-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1149719163WN0300X
KY3016397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0300XNursing Service ProvidersRegistered NurseNephrology