Individual
GWEN ELIZABETH LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 N BROWN ST, SAPULPA, OK 74066-3260
(918) 367-8316
Mailing address
425 N BROWN ST, SAPULPA, OK 74066-3260
(918) 367-8316
Taxonomy
Speciality
Code
Description
License number
State
364SH1100X
Holistic Clinical Nurse Specialist
Primary
NA
OK
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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