Provider Demographics
NPI:1740538438
Name:ISENHOWER, LEIGH ANN (NP)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:ISENHOWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1215 LEE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-297-5651
Mailing Address - Fax:434-244-9433
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-297-5651
Practice Address - Fax:434-244-9433
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170302363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1740538438Medicaid
VAVV7823BMedicare PIN