Individual
DR. MARA HANNIGAN LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, CRNA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(610) 334-3011
Mailing address
1029 DAVANT LN, CHARLOTTE, NC 28209-4096
(610) 334-3011
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
149605
NC
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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