Provider Demographics
NPI:1306940457
Name:HUSTAK, LEIGHANNE KRAMER (CNP)
Entity type:Individual
Prefix:MRS
First Name:LEIGHANNE
Middle Name:KRAMER
Last Name:HUSTAK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:LEIGHANNE
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:143 SANDSTONE RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1082
Mailing Address - Country:US
Mailing Address - Phone:440-243-3742
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05865-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily