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Individual

MRS. LEIGH P DRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
394 COURTHOUSE RD STE A, GULFPORT, MS 39507-1866
(228) 896-4417
(228) 604-0121
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1194
(228) 575-2917

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
784087
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00126282
MS
Enumeration date
01/03/2007
Last updated
10/28/2020
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