Individual
BEVERLY L LEAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
3851 LINCOLN JONES RD, ELLENWOOD, GA 30294-1828
(219) 318-9169
Mailing address
2172 GEORGIA ST, GARY, IN 46407-3212
(219) 318-9169
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0014251381
GA
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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