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Individual

LEAH D FOGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1984 PEACHTREE RD. NW, STE. 515, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
827 W. PONCE DE LEON AVE, DECATUR, GA 30030-2859
(770) 478-9877
(770) 478-2908

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-114291
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN210086
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
822663026A
GA
Enumeration date
05/20/2010
Last updated
08/06/2015
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