Individual
MS. CAROL ELIZABETH LEIDLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1001 12TH AVE STE 102, FORT WORTH, TX 76104-3926
(817) 877-4105
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7900
(682) 207-1030
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP136041
TX
Other
Enumeration date
03/27/2018
Last updated
04/02/2025
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