Individual
SELMA MARIA LEVERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
2448 BEECH AVE, MACON, GA 31204-4021
(201) 208-7521
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN063480
GA
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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