Provider Demographics
NPI:1851477616
Name:FAERBER, LEIGH B (RN, CNM)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:B
Last Name:FAERBER
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 GUNBARREL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7177
Mailing Address - Country:US
Mailing Address - Phone:423-894-1355
Mailing Address - Fax:423-899-8066
Practice Address - Street 1:1751 GUNBARREL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7177
Practice Address - Country:US
Practice Address - Phone:423-894-1355
Practice Address - Fax:423-899-8066
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN5628367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ026371Medicaid
TNQ026371Medicaid