Individual
ANGELA LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
449 W 23 ST, PANAMA CITY, FL 32405
(800) 437-2672
(954) 851-1746
Mailing address
PO BOX 744524, ATLANTA, GA 30374-4524
(800) 437-2672
(954) 851-1746
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9264899
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9264899
FL
Other
Enumeration date
01/20/2017
Last updated
08/19/2019
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