Provider Demographics
NPI:1821002585
Name:WESTERVELT, LEIGH (CRNA / APN)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:
Last Name:WESTERVELT
Suffix:
Gender:F
Credentials:CRNA / APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 ROUTE 73 N
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1226
Mailing Address - Country:US
Mailing Address - Phone:856-581-9711
Mailing Address - Fax:856-581-9712
Practice Address - Street 1:901 ROUTE 73 N
Practice Address - Street 2:SUITE C
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1226
Practice Address - Country:US
Practice Address - Phone:856-581-9711
Practice Address - Fax:856-581-9712
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00263800363L00000X
NJ26NR07599600367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered