Provider Demographics
NPI:1104138601
Name:PANSCH, LEIGH ANN (NP)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:PANSCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10506 MONTGOMERY RD
Mailing Address - Street 2:STE. 402
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4487
Mailing Address - Country:US
Mailing Address - Phone:513-791-6161
Mailing Address - Fax:513-791-4004
Practice Address - Street 1:5300 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2381
Practice Address - Country:US
Practice Address - Phone:937-312-3820
Practice Address - Fax:937-433-9612
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11558-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily