Individual
LEIA JO GUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3000 COLISEUM DR STE 200, HAMPTON, VA 23666-5963
(757) 367-2507
(757) 224-2198
Mailing address
3000 COLISEUM DR STE 200, HAMPTON, VA 23666-5963
(757) 736-7250
(757) 224-2198
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024190296
VA
Other
Enumeration date
09/04/2024
Last updated
12/09/2024
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