Individual
JEANNINE M LEADBEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3241 WESTERN BRANCH BLVD, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541
Mailing address
3235 BRIDGE RD, SUITE 15, SUFFOLK, VA 23435-1778
(757) 606-1656
(757) 606-1657
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101230002
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5611423
—
VA
Enumeration date
04/11/2006
Last updated
07/18/2011
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