Individual
DR. TIERRA NICOLE LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5320 PROVIDENCE RD STE 301, VIRGINIA BEACH, VA 23464-4122
(757) 413-7600
Mailing address
5320 PROVIDENCE RD STE 301, VIRGINIA BEACH, VA 23464-4122
(757) 413-7600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101278323
VA
207Q00000X
Family Medicine Physician
MD474955
PA
Other
Enumeration date
05/01/2018
Last updated
05/16/2023
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