Provider Demographics
NPI:1528217718
Name:POOLE, LEIGH ANN CHANDLER (NP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN CHANDLER
Last Name:POOLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PATRIOT PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6355
Mailing Address - Country:US
Mailing Address - Phone:866-919-1246
Mailing Address - Fax:
Practice Address - Street 1:6521 HIGHWAY 69 S STE N
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6498
Practice Address - Country:US
Practice Address - Phone:866-919-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-065205363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner