Provider Demographics
NPI:1588038186
Name:LEIGHTON, JACLYN N (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:N
Last Name:LEIGHTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JACLYN
Other - Middle Name:N
Other - Last Name:SCHMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 TOWN CENTER DR
Mailing Address - Street 2:203
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8250
Mailing Address - Fax:248-585-8270
Practice Address - Street 1:44201 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1117
Practice Address - Country:US
Practice Address - Phone:248-964-3000
Practice Address - Fax:248-964-8448
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704282963367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered