Provider Demographics
NPI:1801207824
Name:LEAVELL, ALANA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ALANA
Middle Name:
Last Name:LEAVELL
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 1:110 METKER TRL
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-1020
Mailing Address - Country:US
Mailing Address - Phone:606-365-4160
Mailing Address - Fax:
Practice Address - Street 1:110 METKER TRL
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1020
Practice Address - Country:US
Practice Address - Phone:606-365-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1121016363LF0000X
KY3008765363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner