Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leah Raedene Pettry

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1528919479

Leah Raedene Pettry is a Nurse Practitioner in Prestonsburg, Kentucky. Qualified in 2025, 1 year ago. Practices with Mountain Comprehensive Care Center Inc, a 92-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
1
Licensed in
KY
In the registry since
2026
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Practice location Address checks out

104 S Frnt Ave
Prestonsburg, KY 41653-1614
Phone: (606) 886-8572
Fax: (606) 886-4433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 4052731 (KY)

Record details

NPI number1528919479
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 6, 2026
Last updated in NPPESFebruary 6, 2026
Certification dateFebruary 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Mountain Comprehensive Care Center Inc — 92 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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