Provider Demographics
NPI:1629373261
Name:AUSTIN, LEIGH-TAYLOR (FNP)
Entity Type:Individual
Prefix:
First Name:LEIGH-TAYLOR
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1725
Mailing Address - Fax:704-384-1726
Practice Address - Street 1:16525 HOLLY CREST LN
Practice Address - Street 2:STE 150
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4909
Practice Address - Country:US
Practice Address - Phone:704-384-1725
Practice Address - Fax:704-384-1726
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005042363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily