Individual
DR. GWENN LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 E OAK RIDGE DR STE 2000, HAGERSTOWN, MD 21740-7890
(016) 781-8393
(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
163W00000X
Registered Nurse
R185941
MD
207Q00000X
Family Medicine Physician
R185941
MD
363LF0000X
Family Nurse Practitioner
Primary
R185941
MD
Other
Enumeration date
07/20/2016
Last updated
11/23/2022
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