Provider Demographics
NPI:1912313909
Name:PARKER, LEIGH VIRGINIA (CRNP)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:VIRGINIA
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:VIRGINIA
Other - Last Name:HAMMOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:956 W GANTTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-5243
Mailing Address - Country:US
Mailing Address - Phone:334-283-8361
Mailing Address - Fax:334-283-8361
Practice Address - Street 1:440 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3588
Practice Address - Country:US
Practice Address - Phone:224-213-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-093388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily