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Organization
LEATHERMAN HEALTHCARE, LLC
Active
Organization
LEATHERMAN HEALTHCARE, LLC
Active
Other names
Leatherman Healthcare, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GWENN LEATHERMAN DNP-BC (CEO)
(301) 418-5828
Entity
Organization
Contact information
Practice address
118 E OAK RIDGE DR STE 2000, HAGERSTOWN, MD 21740-7890
(301) 678-1839
(301) 679-1740
Mailing address
118 E OAK RIDGE DR STE 2000, HAGERSTOWN, MD 21740-7890
(301) 678-1839
(301) 679-1740
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164875643
FAMILY NURSE PRACTITIONER
MD
Enumeration date
03/08/2022
Last updated
11/23/2022
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